Applied Neuropsychology: Child

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Phonological awareness and rapid automatized

naming as predictors of early literacy skills among
children with mild to borderline intellectual
functioning

Mohammed Alhwaiti

To cite this article: Mohammed Alhwaiti (2024) Phonological awareness and rapid automatized
naming as predictors of early literacy skills among children with mild to borderline intellectual
functioning, Applied Neuropsychology: Child, 13:1, 8-16, DOI: 10.1080/21622965.2022.2106863

To link to this article: https://doi.org/10.1080/21622965.2022.2106863

Published online: 17 Aug 2022.

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APPLIED NEUROPSYCHOLOGY: CHILD
2024, VOL. 13, NO. 1, 8–16
https://doi.org/10.1080/21622965.2022.2106863

Phonological awareness and rapid automatized naming as predictors of early

literacy skills among children with mild to borderline intellectual functioning
Mohammed Alhwaiti
Faculty of Education, Umm Al Qura University, Saudi Arabia

ABSTRACT KEYWORDS
The aim was to investigate the predicting role of phonological awareness (PA) and rapid automat- Early literacy skills; mild to
ized naming (RAN) on early literacy skills (e.g., word reading [WR] and spelling [SP]) among chil- borderline intellectual
dren with mild to borderline intellectual functioning. A total of 68 children in inclusive schools in functioning; phonological
awareness; rapid
grades 1 and 2, from 12 primary schools from Makka, classified as having intellectual disabilities automatized naming;
(ID) of unspecified origin were chosen to participate in this study. Measures of PA and RAN were spelling; word reading
correlated with measures of WR and SP in children with mild to borderline intellectual functioning.
This study advanced knowledge about the predictors (PA and RAN) of early literacy skills (WR and
SP) among children with mild to borderline intellectual functioning.

Introduction of language related to speech sounds (Eissa, 2014, 2017;

Children are taught letter-sound correspondence, spelling,
and how to read words from an early age in Kindergarten
(Vander Stappen & Van Reybroeck, 2018). However, this
process may be more difficult for children with intellectual
disabilities (ID). Compared to their normally developed
peers, children with ID may have considerable difficulties
with some early literacy skills such as word reading (WR)
and spelling (SP) (Eissa & Huseini, 2013; Soltani & Roslan,
2013), as their ability to perform these skills often lags
behind their chronological and mental age.
Mastering WR and SP skills is a vital ability for the
social, educational, and professional development of all chil-
dren. Those with ID are no exception (de Chambrier et al.,
2021). Research on the precursors of reading is of great
importance in order to understand the nature of the under-
lying linguistic and cognitive processes in early literacy skills
(Mostafa, 2017; van Tilborg et al., 2014).
Phonological awareness (PA) and rapid automatized
naming (RAN), although less studied among individuals
with ID, are among the most robust correlates of difficul-
ties in early literacy skills (e.g., WR and SP) (Soltani &
Roslan, 2013; Vander Stappen & Van Reybroeck, 2018).
PA involves knowledge of a particular type of word, as it
is composed of speech elements and can be broken down
into parts of sounds smaller than syllables. This is a mani-
festation of the important spoken language system in early
reading. PA means awareness of the spoken language, as
words consist of a series of small sounds called micropho-
nemic units, and PA is linguistic awareness that enables
the individual to employ information about the structure
Sawi, 2013).
In typically developing children, PA is an essential skill
for learning to read (Eissa, 2017). Many cases of reading dis-
abilities in children, adolescents, and adults can be traced
back to poor PA skills (Dessemontet et al., 2021). In chil-
dren with ID, there is increasing evidence that PA also plays
an important role in reading. It is strongly related to reading
acquisition, and weaknesses in these skills are implicated in
learning disorders (Adlof et al., 2015; Barker et al., 2013;
Sermier & de Chambrier, 2015; Soltani & Roslan, 2013).
However, findings from several studies suggest that PA is
an area of impairment in children with Down syndrome,
Williams syndrome, or Fragile X syndrome compared to
children who typically develop with mental age, verbal skills,
language skills, and reading (Adlof et al., 2015; Laing et al.,
2001; Lemons & Fuchs, 2010; Menghini et al., 2004; Næss,
2016; Steele et al., 2013). The results of the meta-analysis
(Næss, 2016) indicate that rhyme awareness (an important
PA task that refers to the awareness of words that rhyme
and words that do not rhyme) in particular presents a
marked impairment in children with Down syndrome
(Najjar, 2014).
Furthermore, the evolution of their PA skills over time
remains unclear. It is well known (e.g., Eissa, 2017) that
children become increasingly sensitive to smaller and
smaller parts of words as they grow older. Studies with chil-
dren with undetermined etiology within a narrow age range
are not available. Studies examining the PA skills of children
with ID with unspecified or mixed etiologies are scarce.
Borderline intellectual functioning has always been a dif-
ficult concept (Wieland & Zitman, 2016). The term

CONTACT Mohammed Alhwaiti mmhwaiti@uqu.edu.sa Faculty of Education, Umm Al-Qura University, Makkah 21421, Saudi Arabia.
ß 2022 Taylor & Francis Group, LLC

borderline intellectual functioning describes a group of peo-
ple who function on the border between normal intellectual
functioning and intellectual disability, between 1 and 2
standard deviations below the mean on the normal curve
of the distribution of intelligence, roughly an IQ between
70 and 85 (Eissa & Adel, 2019; Hasanin, 2015). Children
with ID usually display a certain degree of phonological
deficit (Eissa, 2013) that may interfere with their perception
of the meaning of print (Al Said, 2014). Despite this, some
authors have listed successful PA interventions for children
with ID. For example, Eissa (2013) explored the effective-
ness of a PA training intervention on pre-reading skills for
children with ID. The results of this study indicated the
effectiveness of the program used in improving the pre-
reading skills of the target children and that the use of PA
intervention programs in the classroom for children with
speech and/or language problems can be effective in train-
ing in PA activities.
PA is seen as “the ability to define and manipulate the
phonemic structure of oral language” (Layton & Deeny,
2002, p. 38), and the acquisition of PA involves learning two
things: first, that PA involves knowledge, and learning that
Words can be divided into parts of sounds smaller than the
syllable, and, second, PA involves learning about the pho-
nemes themselves (Al Said, 2014) and awareness of the
phonological structure of the word helps the student to
identify the relationships between the spoken form of the
word and its written representation.
Moreover, RAN can be used as a useful precursor when
diagnosing reading and attentional problems, particularly in
children aged from 5 to 9 (Areces et al., 2018). It has been
highlighted that children with ID often have difficulties in
reading, display a skewed developmental pattern and weak-
nesses in PA (Channell et al., 2013; Eissa, 2013; Lemons
et al., 2013). Implicit phonological tasks are those in which
phonological processing is automatically performed, such as
verbal short-term memory tasks or RAN (Stampoltzis et al.,
2020). PA and letter-sound knowledge were found to be sig-
nificant predictors of word identification and reading com-
prehension in different profiles of children with ID
(Dessemontet et al., 2021).
The contribution of RAN to reading acquisition and
reading difficulties has also been extensively studied among
normal and learning disabled children (Ara
ujo et al., 2015;
Georgiou et al., 2013; Landerl et al., 2019). Bowers et al.
(1999) proposed that RAN predicts reading because it con-
tributes to the development of orthographic knowledge. Kail
et al. (1999) argued that RAN and reading are related
because they both rely on general processing speed, which is
critical in tasks that require integration of information
within and between sub-processes. Students with dyslexia
scored worse in most PA, RAN, and reading fluency meas-
ures in comparison to their non-dyslexic peers (Stampoltzis
et al., 2020). However, RAN of individuals with ID have
been rarely studied (de Chambrier et al., 2021). A study by
van Tilborg et al. (2014) found that the ID group (7.6 years)
was more than two times slower than the typically develop-
ing (TD) group (6 years). However, the mechanism
APPLIED NEUROPSYCHOLOGY: CHILD 9
underlying the RAN–reading relation is still a subject of
debate. According to the double-deficit hypothesis, PA and
RAN are two separable sources of reading dysfunction (de
Chambrier et al., 2021). Some authors (e.g., Adlof et al.,
2015; Eissa, 2013, 2017; Sermier et al., 2017) indicate that
PA is an area of weakness in children with ID of different
etiologies. In spite of the well-established link between RAN
and reading, key remaining questions exist regarding the
nature of this relationship (Powell & Atkinson, 2021).
Present study
The current study investigated the predicting role of PA
and RAN on early literacy skills (e.g., WR and SP)
among children with mild to borderline intellectual func-
tioning. Previous research (e.g., Eissa, 2013, 2017, Khalik,
2014, Mohammed & Amaal, 2012) has shown that IDs
may adversely affect the reading skills of children; how-
ever, a minimal amount is known about how PA and
RAN contribute to and predict early literacy skills (WR
and SP).
The important role of PA in learning to read for ID chil-
dren was evidenced mostly for reading in languages other
than Arabic language, which is likely to be qualified as a
mixed-bag for orthographic depth (Abu-Rabia & Hanna,
2022; Eissa, 2017; Taha & Saiegh-Haddad, 2017). Arabic has
two coexisting orthographies, voweled and unvoweled. The
former follows phonographic principles, mapping the phon-
emic structure of words, whereas the unvoweled orthog-
raphy uses a consonantal alphabet and follows
morphographic principles, focusing on morphological struc-
ture (Mahmoud et al., 2019). RAN and PA are independent
deficits that impact differently on spelling and reading out-
comes (Torppa et al., 2013).
The aforementioned review of literature makes clear that
both PA and RAN may influence early literacy skills (e.g.,
WR and SP) among children with mild to borderline intel-
lectual functioning. However, until now, to my knowledge,
these two constructs have not yet been investigated within
one design, particularly with children with mild to border-
line intellectual functioning.
Hypotheses
In this study, to gain insight into the predictive role of PA
and RAN to early literacy skills (e.g., WR and SP) for chil-
dren with mild to borderline intellectual functioning, the
following hypotheses were tested.
Hypothesis 1: There is a positive correlation among PA,
RAN, WR, and SP for children with borderline intellectual
functioning.
Hypothesis 2: There are combined effects of PA and RAN
on WR and SP for children with borderline intellectual
functioning.
Hypothesis 3: PA and RAN contribute to WR and SP for
children with borderline intellectual functioning.
10 M. ALHWAITI
PA
word reading
RAN
spelling
Figure 1. Research Model.
Method
Quantitative research was carried out and questionnaires
were used to obtain data from the target children.
Design
A survey method was used. The independent variables were
PA and RAN, while the dependent variables were WR
and SP.
The research model is shown in Figure 1.
Participants
A total of 68 children in inclusive schools in grades 1 and 2,
from 12 primary schools from Makka, classified as having
ID of unspecified origin were chosen to participate in this
study. Each child participant met the criteria for mild to
borderline intellectual functioning (MBIF). ID scores ranged
from 50 to 84, which was consistent with MBIF (Eissa &
Hasanein, 2020). Criteria for these children to be included
were: (a) they are below-average intellectual functioning and
limitations in social and adaptive behavior (American
Psychiatric Association, 2013 ); (b) they have normal or cor-
rected normal vision and sufficient hearing; (c) they come
from families with low to medium socioeconomic status;
and (d) they come from an Arabic-speaking family. All chil-
dren attended inclusion primary schools. All children were
right-handed. Participants were 53 boys and 15 girls. Their
chronological age ranged from 7 to 8 years old with a mean
of 7.8. Their IQ scores using Raven’s Colored Progressive
Matrices Test (CPM; Raven et al., 1986) ranged from 16.57
to 18.59 (M ¼ 17.02, SD ¼ 1.02). Table 1 shows demographic
and diagnostic characteristics of the participants.
Measures
IQ measure
Raven’s CPM is a nonverbal intelligence test, representative
of general intellectual capacity or the “g” factor proposed by
Spearman (Eissa, 2020; Eissa & Al Farahati, 2012). CPM was
developed to assess children aged from 5 to 11 years old,
mentally disabled individuals, and the elderly. The test is
composed of three sets/scales (A, Ab, and B) with 12 items
each. The sum of these sets composes the general score and
Table 1. Participant demographics.
N ¼ 68 children
IQ ranged from 16.57 to 18.59 (M ¼ 17.02, SD ¼ 1.02)
Age ranges from 7 to 8 years old (M ¼ 7.8, SD ¼ 1.033)
Boys 53 (77.9%)
Girls 15 (22.1%)
Socioeconomic status low to medium socioeconomic status
there is no score per scale. The total score is 36. The items
are organized in ascending difficulty over the course of three
sets (A, Ab, and B); the B set is more difficult than Ab on
average, which in turn is more difficult than the A set, on
average. The items consist in a drawing with a missing part,
which the individual needs to complete by choosing one
option among six alternative responses. There is only one
correct answer for each item. The respondents score one for
each correct response and zero for each wrong response.
The minimum score is zero and the maximum score is 36.
The instrument can be applied individually or in groups and
there are no time limitations (Eissa, 2020). Raw scores were
used for analysis. Good reliability (split-half reliability coeffi-
cient ¼ .87) was determined for this task.
PA scale
Six PA tests from a study by Eissa (2017) included Phoneme
Deletion (PD), Phoneme substitution—Beginning Sounds
(BS), Phoneme Substitution—Ending Sounds (ES), Phoneme
Substitution—Middle Sounds (MS), Rhyme Recognition
(RR), and Blending Phonemes (BP).
Phoneme deletion (PD). In the PD test, the initial sound
location is deleted and, as such, the resultant answer is a
non-word. For example, listen to the word book. If you take
away the/b/sound, only/ook/is left (3 items).
Phoneme substitution—beginning sounds (BS). In the BS
test, the child replaces the first phoneme sound of a given
word with a new sound. This task requires adding the new
sound to the beginning. For example, change the first sound
in cat to h. What is the new word?” (3 items).
Phoneme substitution—ending sounds (ES). In the ES test,
the child is prompted to replace one phonemic unit in this
task. The child is asked to change the last sound in that
word to make a new word. For example, if I say the word
can and change the last sound to/p/, the new word is cap
(3 items).
Phoneme substitution—Middle sounds (MS). In the MS
test, the child is focusing on the middle sound in the task.
For example, if I say the word pan, change the middle sound
to/i/, the new word is pin (3 items).
Rhyme recognition (RR). In the RR test, two words rhyme
when they have the same sound at the end. The child listens
to two words and is asked whether they are rhyme or not
and responds yes or no (3 items).

Figure 2. Items in Word Reading Test.
Blending phonemes (BP). In the BP test, the task requires
the child to synthesize or blend each sound in the word. For
example, /k//i//te/ (3 items).
The internal consistency of the survey was measured
through Cronbach’s alpha estimated at 0.87, 0.85, 0.83, 0.82,
0.84, and 0.86 for Phoneme Deletion (PD), Phoneme substi-
tution—Beginning Sounds (BS), Phoneme Substitution—
Ending Sounds (ES), Phoneme Substitution—Middle Sounds
(MS), Rhyme Recognition (RR), and Blending Phonemes
(BP), respectively. A group of 5 experts examined the con-
tent validity. They indicated whether questions were irrele-
vant or highly relevant. All items were highly relevant. The
content validity index at the item level was (I-CVI) ¼ 0.90.
RAN scale
The author designed RAN measures of numbers, letters, col-
ors, and objects based on Denckla and Rudel’s scale (1974)
and on the Arabic Language Book taught in inclusive
schools in grades 1 and 2. The four tests of RAN consist of
a chart containing 60 different items. The items used in
RAN digit were numbers from 1 to 15. The items used in
RAN letter (15 letters) were /s/,/n/,/k/o/s/w/i/n/m/t/e/a/c/d/
b. The items used in RAN color (15 colors) were blue, red,
yellow, purple, white, black, gray, pink, silver, brown, gold,
mauve, cream, olive, and orange. The items used in RAN
object (15 objects) were the pictures of book, plane, kite,
car, house, ladder, spoon, pencil, pen, desk, table, shoes,
cup, glass, and computer. The children were tested individu-
ally. The corrected response was given a point, while the
wrong one was given zero.
The internal consistency of the survey was measured
through Cronbach’s alpha estimated at 0.83, 0.82, 0.84, and
0.86 for RAN digit, RAN letter, RAN color, and RAN object,
respectively. A group of 5 experts examined the content val-
idity. They indicated whether questions were irrelevant or
highly relevant. All items were highly relevant. A content
validity index at the item level was (I-CVI) ¼ 0.90.
WR test
A reading a list of words selected from the students’ book to
ensure that those words are familiar to children was
designed particularly for this study. A card with four col-
umns, where there are 20 words, eight in each column was
presented (see Figure 2). The child is asked to pronounce
APPLIED NEUROPSYCHOLOGY: CHILD 11
the 20 words. This was administered individually. The cor-
rected pronounced word was given one point. While the
incorrect was given zero. Raw scores were used for analysis.
Good reliability (split-half reliability coefficient ¼ .79) was
determined for this task.
SP test
A list of words selected from the students’ book to ensure
that those words are familiar to children was designed par-
ticularly for the SP test in this study. A card with 8 words
was presented. The child was asked to spell the 8 words (see
Figure 3). The children were tested individually. The cor-
rected response was given a point, while the wrong one was
given a zero.
Raw scores were used for analysis. Good reliability (split-
half reliability coefficient ¼ .80) was determined for
this task.
Data were collected through structured self-administered
questionnaires. After obtaining written consents from
parents and the school principal, children were tested in
their schools. Each round of the questionnaire was adminis-
tered by the researcher with the support of the school’s
teachers and conducted in a room other than their regu-
lar classroom.
Invalid questionnaires (n ¼ 6), including those that were
incomplete or provided the same response for all items or
with many missing values, were eliminated. Pearson correl-
ation (R) and multiple regression (MRA) were used to ana-
lyze data.
Children were informed about their role in the study, the
purpose of the study, and the data collection methods. Each
child was encouraged to continue through the end of the
study but were informed that they were free to discontinue
at any time.
Results
Measurement scores of PA, RAN, WR, and SP
Mean, standard deviation, skewness, and kurtosis of PA,
RAN, WR, and SP measures are provided in Table 2.
Skewness and kurtosis values for all measures indicated nor-
mal distributions of scores (Dorothy & Brian, 2018).
12 M. ALHWAITI

Figure 3. Items in Spelling Test.

individual contributions to the prediction of SP. The beta

Table 2. Mean, standard deviation, range, skewness, and kurtosis of weight that represented the relative contribution of the PA
study variables. to the prediction was observed.
Variable Mean SD Range Skewness Kurtosis
PA 10.00 .91 6–12 –.342 .178
RAN 36.22 .98 32–39 –.428 .195 Discussion
WR 11.12 .95 6–13 .132 –.865
SP 3.24 .94 2–5 .376 –.645 As has been shown, measures of PA and RAN were corre-
Notes. PA ¼ phonological awareness; RAN ¼ rapid automatized naming; lated with measures of WR and SP in children with mild to
WR ¼ word reading; SP ¼ spelling.
borderline intellectual functioning. The results imply that
instruction in PA and RAN should facilitate the acquisition
Table 3. Inter-correlations of study variables. of early WR and SP in such children. Results of this study
Variable PA RAN WR SP. also extend the literature on PA and RAN to children with
PA mild to borderline intellectual functioning of unspecified
RAN .622 origin; as noted earlier, participants in most studies in this
WR .636 .661
SP .642 .655 .624
literature have had either Down syndrome or Williams syn-
Notes. PA ¼ phonological awareness; RAN ¼ rapid automatized naming;
drome (Saunders & DeFulio, 2007).
WR ¼ word reading; SP ¼ spelling. PA has been identified as strong correlates of WR and SP
in both typically developing and participants with ID
Inter-correlations (Saunders & DeFulio, 2007; Soltani & Roslan, 2013).
Although some authors in the literature (e.g., Peterson et al.,
Table 3 shows the means and inter-correlations of PA, 2018) found only modest prediction from kindergarten and
RAN, WR, and SP. Table 3 shows that there are significant first-grade PA to the subsequent reading assessments, on the
correlations among PA, RAN, WR, and SP. PA correlates contrary, this study found that PA was a good predictor of
positively with RAN, and SP. RAN correlates positively with WR and SP.
WR and SP. The results of this study are aligned with other research
studies in the literature (e.g., M€
uller & Brady, 2001; Muter
Prediction et al., 2004; Vellutino et al., 2004; Wagner et al., 1994;
Wimmer et al., 1991) which found that PA is consistently
As shown in Table 4, PA yielded an R coefficient of 0.301 found to predict reading and spelling development in the
and Adjusted R Square of 0.311. This shows that 31.1% of normal range; although some other studies conducted within
the total variance in WR of those who participated in the transparent orthographies report that PA is either marginally
study is accounted for by the combination of PA. The table related to early literacy development (Aarnoutse et al., 2005;
also indicates that the analysis of variance of the multiple Holopainen et al., 2001) or diminishes as a reliable predictor
regression data produced an F-ratio value significant at 0.01 after the first two grades (Lervåg et al., 2009; Verhagen
level. The table also shows that PA made significant individ- et al., 2008). Moreover, RAN exerts the greatest influence in
ual contributions to the prediction of WR. The beta weight both WR and SP at this age, which is in alignment with the
that represented the relative contribution of the PA to the findings of Stainthorp et al. (2013) who found that the par-
prediction was observed. ticipants with low naming performance were significantly
As shown in Table 5, PA yielded an R coefficient of poorer spellers overall and had specific difficulty in spelling
0.340 and Adjusted R Square of 0.345. This shows that irregular words.
34.5% of the total variance in SP of those who participated Although findings within and across orthographies are
in the study is accounted for by the combination of PA. The mixed, the general pattern seems to be that the association
table also indicates that the analysis of variance of the mul- between PA and reading is more pronounced in opaque
tiple regression data produced an F-ratio value significant at orthographies than in several transparent European orthog-
0.01 level. The table also shows that PA made significant raphies. One possible explanation of our findings is that the
 APPLIED NEUROPSYCHOLOGY: CHILD 13

Table 4. The regression results (model summary).

Change statistics
Model R R Square Adjusted R Square Std. Error of the Estimate R Square change F Change df1 df2 Sig. F change
1 0.301a 0.307 0.311 4.12034 0. 311 3.441 1 65 0.000
Model Sum of Squares df Mean Square F Sig.
Regression 5.297030 1 5.29.703 4.231 0.000
Residual 9.213733 63 143.1964
Total 14.865430 64
Model Unstandardized coefficients Standardized coefficients t P
B Std error Beta 3.786 0.000
I (constant) 3.460 1.002 0.382
PA 0.346 0.077 3.697 0.000
Notes. aPredictors (constant), PA ¼ phonological awareness.

Table 5. The regression results (model summary).

Change statistics
Model R R Square Adjusted R Square Std. Error of the Estimate R Square change F Change df1 df2 Sig. F change
1 0.343a 0.340 0.345 4.56382 0. 345 3.601 1 65 0.000
Model Sum of Squares df Mean Square F Sig.
Regression 6.647030 1 6.647030 4.446 0.000
Residual 10.813766 63 171.647079
Total 16.865030 64
Model Unstandardized coefficients Standardized coefficients t p
B Std error Beta 3.889 0.000
I (constant) 3.840 1.002 0.398
PA 0.366 0.070 3.711 0.000
Notes. Predictors (constant), PA ¼ phonological awareness, SP ¼ spelling.
a

Arabic language is a combination of both opacity and trans-
parency. As Abu-Rabia and Hanna (2022) stated, “Arabic
belongs to the cluster of languages known as ‘Semitic lan-
guages.’ Unlike other Semitic languages, spoken Arabic dif-
fers from one geographic location to another. This
difference is expressed and reflected in practically all of the
linguistic fields: phonological, morphological, syntactic and
semantic.” (p. 301).
Again, results of this study align with other research
studies within the literature that have shown that RAN pre-
dicts later literacy performance in both transparent and opa-
que orthographies (e.g., de Jong & van der Leij, 2002;
Georgiou et al., 2008; Kirby et al., 2003; Lervåg et al., 2009;
Wimmer et al., 2000)
Thus, the overall impression from the present analyses is
that there are more similarities than dissimilarities in the
prediction of reading from PA and RAN in different lan-
guages. Much less is known about the association between
RAN and SP. The few studies that have investigated this
relationship in English report that RAN predicts SP concur-
rently (Savage et al., 2008). The findings of this study,
although in the Arabic language, concur with these findings,
which proves the flexibility of the Arabic language.
Conclusions
This study advanced knowledge about the predictors (PA
and RAN) of early literacy skills (WR and SP) among chil-
dren with mild to borderline intellectual functioning. In this
regard, if the suggestive measures proposed in this study for
children with mild to borderline intellectual functioning can
be implemented, it will positively impact early literacy skills
(WR and SP) among children with mild to borderline intel-
lectual functioning. In theory, the findings will provide a
theoretical reference for future research on PA and RAN
utilization as predictors and better understand these influ-
encing factors on early literacy skills (WR and SP). In prac-
tice, this is conducive for the promotion of PA and RAN for
the improvement of early literacy skills (WR and SP) among
children with mild to borderline intellectual functioning.
Finally, the assessment and better understanding of reading
precursors in children with ID may contribute to the devel-
opment of more effective intervention.
Limitations and future research
There are some limitations of this study that need to be
addressed in future studies. First, because of the nature of
this study, children were tested only once on all variables.
As a result, it is not likely to tap into the development of
early literacy skills. Future research needs to follow a longi-
tudinal perspective, in order to strengthen the relationships
between the variables and the reliability of the hypotheses,
and for the possibility to investigate the development of
early literacy skills in children. Second, the number of chil-
dren was small. Therefore, findings of the present study
need therefore be interpreted with caution.
Institutional review board statement
Not applicable.
14 M. ALHWAITI
Informed consent statement
Not applicable.
Disclosure statement
The author declares no conflict of interest.
ORCID
Mohammed Alhwaiti http://orcid.org/0000-0002-0048-7387
Data availability statement
Data sharing not applicable. The data are not publicly available due to
participants’ privacy.
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