Chapter 7 – Assistive Technology for Reading Introduction 1 Using the sett process 7 Decision Making Guide 8 sett process 9 Reading Continuum 14 Reading Continuum

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Book Adapted for Access

Physical Access

If a student has a physical disability that makes it difficult to handle books, pages can be made easier to manipulate. Putting something in between pages to separate them makes it possible to slip a finger between the pages. These “page fluffers” can be anything that works well for the student. An easy way to make “page fluffers” is by adhering pieces of lightweight foam or sponge to a piece of tag board. These can be cut into one inch squares and then paper clipped to each page. A small piece of the soft side of sticky-back Velcro can be stuck to the corner of each page as another “page fluffer”. Any lightweight item that will sufficiently separate the pages will work. Some students simply need a way to “grab” pages. You can use large paper clips or Hefty Post-it® tabs, or the student can try wearing an office “rubber finger” to grip individual pages. It is also important to consider the physical placement of the reading material. Often an easel is used to hold the reading material in an upright position so the student can easily view it.

Automatic page-turners such as Flip by AbleNet® can turn the pages of a book or magazine when the student presses a switch. Reading materials are inserted in the page-turner, adjusted and activated by one or more switches depending on the student’s needs. They can be programmed for automatic dwell times that can be adjusted depending on the user and reading material.

The BookWorm Literacy Tool from AbleNet is a device that makes almost any children’s book a "talking book." Record the text of each page of a children’s book into the BookWorm literacy tool and affix the matching stickers. Students press the keypad or use an external switch to listen to the recorded pages of the book as they read.

AAC Users
Students with Severe Speech and Physical Impairments (SSPI) who use communication devices generally need special accommodations for their reading instruction. As students with SSPI develop reading skills, teachers can program building words activities, phonetic exercises, word banks/walls, vocabulary pages, and more into the student’s communication system. As the student’s reading skills progress so will the overlays/pages the student uses to support their reading. They may have overlays to ask and answer comprehension questions, word definition pages, vocabulary to express prior knowledge before reading text or even have replicas of books, pages or repeated lines on their device so that they can read independently or as part of a group reading activity. These students require the support of Speech and Language Pathologists in addition to their special and regular education staff in order to meaningfully interact with print. One literacy program, MEville to WEville by AbleNet uses standard children’s books with specific adaptations for students with limited communication skills. The program suggests possible communication devices and activities for those students. For more information about students with SSPI, please see Chapter 3 – Assistive Technology for Communication.

Visual Modifications
Special adaptations of text need to be made for students with visual impairments; books can be converted to Braille or large print, text can be copied and enlarged on a copier or low-tech tactile cues can be placed in the book. All are adaptations that could be appropriate for students with visual impairments. Students who need Braille copies of text or large print books can receive those from vision support services-local, state or national.

Some students without an identified visual impairment might also benefit from large print because of visual processing deficits, problems with tracking words in a sentence, identifying word borders/boundaries or other impairments. A low-tech solution might be enlarging the page on a copy machine. While you can only enlarge to a certain point before cutting off text, it might be enough to relieve the visual fatigue that some students experience without even knowing it. Some students with sensory impairments benefit from tactile cues such as pieces of textured material glued on the page to illustrate a concept (soft, scratchy, smooth), or glue or puffy paint to outline a shape in the book.

Others may benefit from using hand-held magnifiers. Although you can find low level magnifiers at retail discount stores, be aware that their clarity and magnification are less accurate than those developed specifically for individuals with visual impairments. Some students may improve their ability to track the words in a line using a bar magnifier. Vision specialists should be consulted about high quality magnifiers for students with identified visual impairments. Please see Chapter 12 - Assistive Technology for Students who are Blind or have Low Vision, for more adaptations for students with visual impairments.

Low-Tech Modifications to Text

Changing the Readability of Text

When students need standard text or curriculum slightly modified, there are some low-tech solutions. Using Wite-Out® on challenging vocabulary and replacing the words with easier synonyms can change the readability of the text. Another solution is to summarize the text on the computer with easier vocabulary and less details. Paste the summary over the existing text so that the student’s book “looks” like their peers. Enlarging the font, increasing the line or word spacing, or increasing the margins on the document so that fewer words are on a line can increase readability. Once again, that modified text can be glued over the existing page.

Marking Text

Color coding, either with highlighters, Highlighting Tape, colored text printed from the computer or any other means can give students a visual clue to identify important vocabulary, facts, main ideas, recurring “trouble” words, where to start/stop reading, repeated lines or whatever the skill the student needs support for.

Independent Reading

If students need individual vocabulary words or short phrases/sentences read to them, the text can be printed on Language Master cards and recorded by the teacher. Students can then run the card through the Language Master or similar card reader to hear the text read aloud as many times as needed. Other reading supports such as spelling the words, giving definitions or synonyms to unfamiliar vocabulary, and syllabication cues can also be recorded on the cards.

Handheld Device to Read Individual Words

Talking Dictionaries

The various talking products such as those from Franklin Electronic Publishers are especially helpful for students who stumble over new words or larger words as they are reading. The student types in the trouble word and the talking spell checker/dictionary/thesaurus will pronounce it. There are a number of these products. Some of the devices let you enter a word list so that the student can scroll through the list; looking for the word they are unsure of and select the word to hear it spoken. It clarifies homophones such as too, two, and to. The phonetic spelling correction lets the student look up a word even if he doesn’t know how to spell it.

Reading Pens

A single word scanner can be of great help to an advanced reader who struggles with large, multi-syllabic or unfamiliar words. A device such as a Readingpen® from WizCom Technologies LTD. can be an excellent tool. It can be moved across the unknown word or line of text either from left to right or right to left. It scans the word or line of text and uses built in optical character recognition (OCR), to pronounce the word or read the line of text. It provides the definition if needed, speaking it on some models. A thesaurus is also included on some versions. This is not a tool for a young reader, one who struggles with many words in a passage, or has visual/motor difficulties. However, it can be a good match for the right student. A similar device, the QuickLink Pen® Elite from WizCom Technologies LTD also speaks entire lines of text. Unlike the Reading Pens, it stores the scanned text into the pen to be transferred later to a Windows® based computer. The IRISPen series are pen scanners that transfer scanned text into Windows or Mac® applications. They are small and lightweight and connect to a computer using a USB cable. Some versions have text to speech technology.

Use of Pictures/Symbols with Text
Adding pictures to text can be very helpful for students who struggle with reading text. Using pictures together with words not only strengthens the association of text with vocabulary but also allows struggling readers to more easily comprehend what is written. Seeing words illustrated makes the text more meaningful and easier to remember. This is a strategy that has been reported as being effective for emerging readers (Silver-Pascuilla, H., Ruedel, K. & Mistrett, S.).

One example of software that easily adds rebus symbols to text is Picture It. Picture It from Slater Software allows the teacher or therapist to enter text and quickly add rebus symbols. Rebus symbols are added to the entire passage with just the click of one button. One way to adapt books is to paste with adhesive picture-supplemented text over the traditional text. Picture It software consists of a library of over 6000 pictures/symbols linked to words, including the 100 most commonly used words. Customized pictures can be imported into the library. Pictures can be placed above or below the text and reduced in size so that as the student increases his or her reading ability, the text is more prominent than the picture. If necessary, the picture-supported text can also be read to the student by the computer and is accessible by switch, touch screen, keyboard or mouse.

A typical line might look like the following text from Monkey Business at the Market© (1994) by Jean Slater.

When a student no longer needs the support of pictures, he will tend to stop looking at it and naturally fade its use. The teacher can also reduce the size of the graphic while enlarging the size of the text so that it has increased prominence on the page. Clicker5, Writing with Symbols 2000, IntelliTools® Classroom Suite, PixWriter™ and Boardmaker are software programs that can be used to supplement text with pictures. Slater Software, the developers of Picture It have a free online service, Literacy Support Pictures™ which supplies symbols for words entered into their search window.


® is a weekly online newsletter with picture supports for beginning readers. This weekly downloadable newsletter consists of an 18-20 page edition of current events, jokes, a recipe and activity pages. The simplified version of the same newsletter includes communication boards that support the newsletter. The “higher edition” has fewer picture supports and higher-level activities. The subscriber does not need to have specialized software to download and view the pictures. A speaking edition of the News-2-You newsletter is available if you have the free software Flash installed on your computer.

If a student could benefit from just a few pictures to support general concepts or key words, you might consider using a standard word processor for the text and add images to the document. You can use digital pictures, clipart or download images from the internet using a search engine set for images or other software programs that have a graphic library to illustrate key points or vocabulary.

Electronic Text

Electronic text allows you or the students to manipulate or access the text in ways that would not be possible using standard printed text. Words can be seen and heard when used with a text reader. Electronic text is abundant and comes from a variety of sources:

  • Commercial

  • Free downloadable

  • Subscription-based downloadable

  • CD included from some publishers when a hard copy of the text is purchased

  • Scanned from a paper copy

  • NIMAS text from an authorized entity

These are just a few of the many available resources. A more comprehensive listing of electronic resources for reading follows at the end of the chapter.

Commercial e-books

The following commercial products are highlighted because of the accessibility features that are built in. Electronic books or e-books are another way to allow students with physical disabilities to interact with text. When they are well designed with accessibility features, they offer a way for students to interact with the text. They are especially useful for students with physical disabilities who may not be able to hold or turn the pages of the regular text version. But they can also be a good choice for other students with other disabilities. Generally these programs read stories aloud to students in digitized (recorded) speech. Many have colorful graphics, music and sound effects. The students can interact with both the text and graphics. Here are just a few of those available.

IntelliTools Reading: Balanced Literacy program incorporates guided reading, phonics and writing through theme based stories including song, rime, and patterned language activities. The Balanced Literacy program includes nine full-color original storybooks, 142 lessons, 117 letter, pattern and decodable minibooks, 212 phonics activities, and 27 writing exercises. It also includes 46 colorful IntelliKeys ® overlays that support IntelliKeys users and customizable options including one for low vision.

LeapFrog® products are commercially available at discount stores or over the Internet. They have a variety of learning systems, books, pads, and other digital devices that can read text, spell and interact with the student in a variety of ways. They have products suitable for students from infancy through secondary. While not developed to be assistive, they provide reading supports for many students by reading and spelling words, adding meaning to a term or concept, asking comprehension questions and more.

Planet Wobble from Crick Software is another series that provides hard copy and on-screen books. Activities included in the series are based on specific literacy objectives such as repeated text for the first series, word study, comprehension activities and writing activities. These activities are differentiated, enabling children of all abilities to use them and are switch accessible. The series of books and activities provides progression through three levels. Planet Wobble books must be used with Clicker software.
Start-to-Finish® Books from Don Johnston Incorporated are high quality literature based stories. The stories come with a CD, a hard copy of the book that looks age-appropriate and an audiotape. The CD includes the text in exactly the same arrangement as in the book. Some of the stories in the series are classics that have been rewritten with high interest, controlled vocabulary (e.g., Treasure Island, The Red Badge of Courage). Others are new stories that have been written specifically for the series. The Gold Library includes titles with grade 2-3 readability, syntax and vocabulary of conversational speech, easily decodable words and a limited number of ideas per sentence. The Blue Library includes titles with grade 4-5 readability, syntax and vocabulary of more formal English; more ideas introduced into longer sentences with varied sentence structures. All Start-to-Finish Books include built-in scanning for single switch users. Each Start-to-Finish title includes teacher support materials, guided reading levels, lexile levels, PDF files of activities that include vocabulary and word study, plot and character development activities, cloze passages, multiple-choice quizzes and open ended questions for each chapter. Titles cover history, literature, science and nature, mystery and sports.
Start-to-Finish Literacy Starters are written and edited to match the interests and issues of older beginning readers. The content and graphics are more mature but take into account the barriers of language, syntax, and vocabulary that would make text difficult to read or comprehend for a beginning reader. Start-to-Finish Literacy Starters uses a proprietary combination of three text types—Enrichment, Transitional and Conventional—to provide the support for different skill areas: print conventions, oral language development, alphabetic principle and phonological awareness. All Start-to-Finish books and materials are read to the student using recorded speech from an actor rather than synthesized computer speech. The student or teacher can set the books to highlight word-by-word, by line or sentence as the text is read.
Thinking Reader from Tom Snyder Productions is a software series of electronic books developed to provide support for struggling readers. The program trains students to read strategically in order to increase their comprehension. Specifically designed for Grades 5-8, the Thinking Reader series presents unabridged, grade-level literature via the computer screen combined with human voice narration.

UKanDu Little Books ® are switch accessible simple books for emerging readers. Students can choose words to complete the sentences on each page and create their own stories. When finished, the story is read back to the student and can be printed for a hard copy.

WiggleWorks® by Scholastic is a complete instructional program that features electronic versions of several excellent children's books. Students can click on unfamiliar words to hear them read aloud, record themselves as they read the book, and write or dictate their own books, which the computer can read aloud. Customizable features allow teachers to choose how text is read and highlighted and customize text size, background color, recorded sound, and graphics. It has an on-screen keyboard and is single-switch accessible.
There are many other sources of e-books available. If you would like to know names of more electronic books you can visit the website of Project LITT: Literacy Instruction through Technology which conducted a three year study of the effectiveness of hypermedia based children's literature in improving reading skills of students with learning disabilities.
Free e-books (downloadable)

There are several excellent websites that provide access to electronic books. Starfall Learn to Read is a free website featuring a multitude of stories appropriate for Early Childhood through second grade. Stories are categorized according to early emergent readers through advanced emergent readers. The website allows the user to highlight words and have the words sounded out for the reader.

International Children's Digital Library (ICDL) is a five-year project funded by the National Science Foundation (NSF) and the Institute for Museum and Library Services (IMLS) to create a digital library of international children's books. One goal of this project is to create a collection of more than 10,000 books in at least 100 languages that is freely available to children, teachers, librarians, parents, and scholars throughout the world via the Internet. This website provides scanned images of the books but does not read the book aloud for the student.
Text and books that were written more than 50 years ago are now in the public domain and can be downloaded from the Internet by going to the Project Gutenberg site. These wonderful stories and novels can be adapted for use with older students who are still struggling with reading but would enjoy a more complex story line. is a web-based system supplying current accessible books in digital formats designed for people with print disabilities. These digital formats are in NISO/DAISY format for talking books, and BRF format for Braille devices and printers. Access to copyrighted books from is limited to people in the United States with bona fide print disabilities and the non-profit organizations serving them. Bookshare requires an affidavit of print disability. Bookshare has partnered with Don Johnston, Inc. to offer a free edition of Read:OutLoud®. Eligible members will have full access to the NIMAS compliant reader complete with study skills tools.
Teacher Tap is professional resource for educators that lists electronic text with and without pictures, audio texts, interactive stories and more. The site is organized according to reading level, content, lists and collections, etc.
UDL Editions by CAST take advantage of the flexibility of digital text and power it with a text reader, highlighters and other study tools using the Texthelp© Toolbar and animated reading “coaches” that provide leveled supportive reading strategies.

Fee based e-books

Some organizations offer electronic books to schools or individuals with disabilities for a modest fee. Most require a written proof of disability.

Accessible Book Collection

Books are listed by reading level, grade level and word count. They have specific high interest/low vocabulary books listed. Many of their books include illustrations and are switch accessible. The annual membership for schools requires a certification that the books will be used with students with disabilities.

One More Story

E-text subscription service that uses recorded voice with e-text. Offers books in a library format. Booklist mirrors frequently used elementary reading books.

Reading A-Z

Provides access to leveled readers, lessons, Benchmark books with running records, phonemic, phonetic and alphabet activities, vocabulary, assessments and more.


Tumblebooks for early readers are adapted by taking existing picture books and adding animation, sound, music and narration to produce an electronic picture book that either the child can read or have read to them. Older readers have a separate library of chapter books, high interest/low level, literature and more that have been adapted with narration, highlighting options and adjustable online text.

Publishing houses, including those that provide curriculum for schools and commercial sites ( are also resources for digital books that can be purchased.
Handheld ebook readers and applications

Many of the handheld devices, PDAs and ebook readers can be used as an assistive tool for reading text. Ebook readers hold hundreds of pages, can enlarge the text and may be physically easier for students to turn pages. Many come with MP3 converters, so a student may be able to listen to the text while reading it.

The Amazon Kindle and Cybook are examples of portable reading devices that can hold hundreds of titles including books, magazines, newspapers, documents, and pictures. They use “electronic paper”, with the readability of paper and adjustable font size. Students can add bookmarks and annotations, copy and paste passages and then export them. Some of the devices are wireless, others use USB connectivity. Portable reading devices read text using a proprietary format, thus most text is not interchangeable between devices.
TouchBook uses Touch User Interface (TUI) technology. By pressing the surface of a printed page that is TUI-enabled the reader is able to retrieve digital content such as definitions, links or bookmarks that are stored on the computer, websites, DVDs, and CDs.
Children’s Illustrated eTales is a Palm application of four short stories with colorful illustrations for students Kindergarten through Grade 2. On Palm OS handhelds, Palm eBook Studio allows ebooks to be created, formatted, and converted for reading on a handheld.
Digital audio book readers such as the EZDaisy Talking Book Player and Scholar Talking Book Player by Telex Communications, Inc. or VictorReader® Stream by Humanware are designed for students with a vision or learning disability. These hand-held book players read DAISY files and can convert digital text into audio files, and feature navigation controls, audio formats including MP3 and variable speed control. Because they are digital, students don’t have to worry about tapes or CDs. The Scholar and VictorReader Stream includes additional features such as bookmarking and “Go To” options. In addition to playing audio files in an MP3 format, the digital book reader, ClassMate Reader by Humanware also visually displays text with a highlighting feature so that students can see and hear the text read using the portable device. It also includes study skills features, the ability to create voice and text notes, bookmarking options, a dictionary and the ability to listen to audio only files. Some of the readers use “human-like” voices while others use high quality synthesized voices. They can all hold literally thousands of books on flash memory cards. Humanware reported a study in which 29 “college-bound” students were instructed in the use of and had access to a ClassMate Reader over a 24-week period. At the conclusion, the study reported that students read electronic text for significantly longer time periods than printed text (4.7 hours compared to 1.46) and self-reported an increase in comprehension of the electronic text when they could see and hear the text being read ( Retrieved 11/20/08)
Audio Texts

Audio-only texts are a resource that should be considered for some students given the technology available and used within the mainstream. Students can listen to audio books on CD players, playaways, MP3 players, cell phones, iPods and other handheld devices and/or the computer. Because audio formats are familiar to so many students, they may be more accepting of audio books as an alternative format than other options. One study showed that secondary level students with mild disabilities performed higher in content assessments when they used audio texts compared to standard print based text (Boyle, Rosenberg, Connelly, Gallin, Washburn, Brinckerhoff, & Banerjee). Text files can be converted to MP3 files, WAV files, AAC files (for iPods), or a number of other audio formats. The software for MP3 and AAC (iTunes) playback is available for download at no cost, and many text-reading programs have MP3 players built in. Another option for audio text is to create your own podcast of short books, chapters, tests or other traditional text. A podcast is simply an audio file that is recorded to be downloaded at a later time. Students can download the podcast and listen either on the computer or a portable media player. Podcasts can be created using a telephone (gcast) or using free or commercial programs. Audio files come in many different formats, each geared to be played by specific media players. Not all are interchangeable.

Audio files of text are also available from different sources. Audio books are available from commercial web sites such as Amazon and iTunes. Audio books are also available from Recording for the Blind and Dyslexic®. This organization provides audio books for students with a verified print disability for a fee. They provide a list of compatible portable media players for RFB&D audio files at
Playaway® self-playing digital audio books from Follett Library Resources come ready to play. They are self-contained single audio books complete with a battery, earbuds and a lanyard. The device has a simple interface with 8 buttons to play, increase or decrease the narrator speed, navigate throughout the book and bookmark pages. These may be available at the local public library.
A slightly different format from a standard MP3 player is the FP™3 Player from Fisher-Price. This is a child friendly player with large navigation buttons, volume control and a graphic representation of books and songs that are listed on the player. Books can be downloaded from the Fisher-Price website (fee) or converted from existing CDs using the software from the player. Media must be converted into the specific format for the FP3 Player and is not compatible with MP3.
Text-to-Audio© by Premier Assistive Technology, Inc. is a tool that converts text documents to sound files. Text-to-Audio can create 10 different types of audio output files including MP3 and WAV files. It compresses files as it creates them. Text-to-Audio uses AT & T’s Natural Voices to produce high quality digital-speech audio. The WAV or MP3 files that are created can be played back using an MP3 player or on the computer. They could even be burned to a CD to be played later by the student.
There are many resources available for teachers to convert text into some type of audio format. While this is a format that many students are familiar with on a recreational basis, they may need support in comprehending the text, navigating through multiple pages and building good listening skills. Teachers who need support in teaching those skills may want to use websites such as Learning through Listening from Recordings for the Blind and Dyslexic. Lesson plans, research articles and other downloadable materials are available regarding teaching listening skills even if your school doesn’t subscribe to the service.

Modified Electronic Text

When reading materials are electronic, the text becomes flexible and can be reformatted or transformed into accessible alternative formats. Text can be enlarged, format can be adjusted with more spacing between words or lines, or presented in high contrasting colors to make it easier to see. Once text is in a digital format, it can be read on the computer, word definitions can be spoken or students can click embedded links for a multimedia presentation of the content to increase understanding.

Using digital text makes format changes easy to do which may actually increase the readability of the text for a student.

In this example, you or the student can “Select All” of the text from the Edit menu of the word processor application and select a larger font size (Times New Roman 16pt).

Some fonts (such as Verdana 14pt) may be easier for students to read than others, so the student may use the same procedure (“Select All”) to change the font type to one that is easier for them to read. There is no research to support the claims of readability of typeface. However personal preference does make a difference.

Other students may have difficulty tracking words and need increased space between lines. “Select All” and increase the line spacing to 1.5 or double line spacing. These sentences use the same font and size as the rest of the text, but are double-spaced.

It is also possible to change the spacing between words. In this example the “Select All” feature is used to change the spacing between words. Type one space in the “Find” window and two spaces in the “Replace” window. Having more spacing between words may assist those students with “word boundary” problems who have difficulty seeing where one word stops and the other begins. This sample inserted two spaces between words.

Another formatting change may be to increase the

margins so that fewer words appear on the line.

Students with difficulty tracking the words across

a page may be more successful when there are fewer

words per line such as in this example.

If the student is more successful using a colored overlay (see Using Color with Standard Text), change the background color on the computer by going to the “Format” menu, then “Background” to replicate the colored overlay on the computer. Use color to bring key words to a student’s attention by using the “Find/Replace” options again. This time insert the key word in the “Find” window and “Replace” it with the same word, except change the format font to a colored one or highlight selected words and change the text color.

Some students need the text simplified for them. If the document is in Microsoft Word® 2003, you can “cognitively reformat” the text by using the AutoSummarize function in the “Tools” menu. Select the type of summary (highlight key points, executive summary, new document or hide everything but the summary) and the percentage of the original document included in the summary. As with any curricular modifications, you or the content teacher may need to adjust the summary to insure that it matches curricular objectives and benchmarks.

The AutoSummarize feature is still present in Microsoft® Office 2007, but is in a different menu location.

The AutoSummarize tool now appears on the Quick Access toolbar which may need to be installed. Directions to do so can be found in the Help menu. To create a summary of the document:

1. Open the document you want to summarize.

2. Click the AutoSummary tool on the Quick Access toolbar.

3. Choose Auto Summarize from the submenu that appears.

4. In the Type of Summary area, specify which of the four summary types you want to create.

5. In the Length of Summary area, indicate by using the Percent of Original drop-down list exactly how long you want the summary to be.

6. Click on the OK button.

Remember to show students other helpful features of Microsoft Word such as inserting bookmarks for easy navigation (to glossary, chapter questions, table of contents) or returning to the last page read, using different “Views” like the “reading layout” and using the Thesaurus and Dictionary (right click on Windows, Control + click on Mac) as they encounter unfamiliar words.

nstructional staff can insert comments as pre-reading or summary questions or definitions in the text to assist a student’s comprehension by using the “Review” Toolbar. Click on “New Comment” and insert a question, definition, definition or statement to encourage student reflection of the text.

One software program that can create most of the above-mentioned modifications for e-text is CueLine ED from Onion Mountain Technology. It allows you to control the presentation of electronic text on the computer screen. You can change font, background and margin (cue line) colors, adjust the font size and alignment, decide the number of lines per screen, the distance between those lines, and the number of words on each line. A left click takes the student to the next page, and a right click reads the text on that page to the student. Color cues can be attached to the left side of the screen to visually cue the student to sweep back to the left side.

Visual Thesaurus® is an online interactive dictionary and thesaurus with a display much like a semantic map. The graphical map displays the connections between a word and its definitions and synonyms in a unique display that can increase understanding and comprehension.
Modified text can come in a variety of types, formats, genres, and ability levels. Route 66 is a website that contains modified high-interest low-vocabulary text for beginning adolescent and adult readers with significant disabilities. An “e-tutor” assists the reading partner in supporting the student in reading, writing and word study.
Classic Book Shelf allows students to adapt literature “classics” to a more readable format and presentation. Students can adjust font size and type, colors, margins and more. Students can even bookmark pages and later return to read.
Symbol World has modified newsletters, stories and more with pictures and rebus symbols for students who need picture supports.
Please review the Internet Reading Resources pages at the end of this chapter for more listings of online resources.

Create your own modified electronic books

You can create your own electronic books and text by using many software programs. Creating personalized books that students can relate to can be motivating to reluctant readers or students with emerging literacy skills. Kid Pix ®, HyperStudio ®, IntelliTools Classroom Suite, My Own Bookshelf, CAST UDL Book Builder (a free online program), PowerPoint®, Buildability, SwitchIt Maker 2 and Clicker are examples of software that can be used to create electronic books for beginning readers or advanced readers who need accessibility features built in. Clicker and IntelliTools Classroom Suite also have online resources such as books and activities that other educators have created and are available to download. KidBook, a free download for Macintosh is available from Switch in Time’s website. The program is appropriate for all ages and literacy levels. It enables users to convert all standard books into electronic documents that can be highlighted, magnified, colored, and speech-synthesized. Another simple way to create digital books is to literally take a picture of each page of the book using a digital camera, the built in camera available on some computers or an inexpensive “web cam”. After the digital picture has been transferred to the computer, it can be imported or copied into any of the programs listed above. Add text and recordings to create your own electronic book. Many of the software programs have switch accessibility built in or the program can be modified so that it will work with a switch.

Modified text for the Hearing Impaired

Many students with hearing impairments have a difficult time learning to read English. In fact, at the time of high school graduation, the average Deaf/HH student reads at or below the 4th grade level even though they understand and use sign language at a much higher level. (There are many reasons for this occurrence that can be found in Chapter 13 – Assistive Technology for Students who are Deaf or Hard of Hearing). For these students, written English is a second language that they don’t have the luxury of hearing or practicing. Students who are deaf or hearing impaired can benefit from specialized software that uses 3-dimensional signing “avatars”. These realistic animations provide students with sign language translations of vocabulary and assist with comprehension and fluency. Sign Smith™ products from Vcom3D provide signing translations within a dictionary, a studio program and signing animations, all of which can help students learn word meanings and make the connections between English text and American Sign Language (ASL).

Modified text for the Visually Impaired

Computer operating systems have accessibility features built into them. Accessibility features are generally found in the Control Panel and/or the Accessories and Settings menus. The display can be set with a higher contrast so that text stands out more clearly against the background. Magnification options enlarge the entire display or portions of it. Resolution and display settings make icons on the desktop bigger. If students need enlarged text on their web browser pages, go to where you can find instructions for enlarging the text on any web browser. Please read Chapter 12 – Assistive Technology for Students who are Blind or have Low Vision about other modifications for students with visual impairments.

Text Reader
Research Supporting Text Readers

Using a simple text reader has been an accepted accommodation for students with reading disabilities. Educators have been using text-to-speech (TTS) software and TTS functions of computer operating systems for a number of years. But what does the research say? It’s been assumed that converting text-to-speech will improve the reading abilities and comprehension of students with reading disabilities. Silver-Pascuilla, et al. reviewed the research about the effectiveness of TTS with students with disabilities. They report that

  • TTS helps special education students improve comprehension, fluency, and accuracy and enhances concentration (Leong, 1992; Lundberg & Olofsson, 1993).

  • Word recognition skills also improve with this technology (Olson & Wise, 1992).

  • Being able to immediately decode a word by hearing it spoken within the context of a passage helps students build word recognition and vocabulary without disturbing the flow of comprehension (Califee, Chambliss, & Beretz, 1991).

  • Comprehension is augmented by supporting decoding, thereby freeing the listener to focus on the meaning of the text (Wise, Ring, & Olsen, 2000).

  • These technologies provide a supportive reading environment and increase a student’s ability to read interesting and appropriate grade-level materials by minimizing the need for decoding skills and maximizing the student’s ability to comprehend (Silver-Pascuilla, H., Ruedel, K. & Mistrett, S., p 24).

Elkind and Elkind (2007) interviewed secondary and college-aged students about their use of text readers. They found that

  • 93% of the students with learning disabilities reported that reading was easier, less stressful, and less tiring.

  • 91% of students with learning disabilities said that they were able to increase the time that they could sustain attention to reading before their attention wandered or they needed a break.

  • The average duration of sustained reading reported by stu­dents with attention disorders increased about 60%, from 30-40 minutes to 50-60 minutes.

  • The combined effect of faster reading speed and longer read­ing durations can result in a dramatic increase in the amount of material that a slow reader can read in an extended reading ses­sion of several hours. Some slow readers saw improvements in the number of pages read by factors of 2 or 3.

Research about using Text Readers

The Iowa Assistive Technology Text Reader Project (Maurer, Dimmitt, Hodapp, Judas, Munn & Rachow, 2006) was a statewide project that studied the impact of using a text reader on student achievement and attitudes. The Iowa Study specifically used Kurzweil 3000 as their text reader; however the effects of using text-reading software could be generalized to any of the previously mentioned programs. The study documented improved reading fluency and comprehension as well as very positive subjective responses from the students and teachers implementing the text reader project. Data indicated that there might have been an initial adverse effect on student’s performance while they were learning to navigate within the software. However, as they became more familiar with the program, their performance improved. Week 13 was the tipping point when students move from the acquisition process to the implementation process and their comprehension scores improved. The final results of the three-year study indicates that students accessed twice the amount of material (160 words per minute using the computer vs. 79 words per minute using paper probes) using text reader software rather than conventional means (2008). Additionally, while the student’s comprehension of the paper text declined as the text difficulty increased, they were able to maintain and even improve comprehension levels using the text reader with the more difficult text. It should be noted that rates of satisfaction and greater gains were observed over the second year for both students and teachers.

Text Readers as part of the computer operating system

Prior to purchasing or downloading a free text reader, look at your own computer operating system. Macintosh OS® has long had text-to-speech (TTS) built into their operating system. TextEdit is a simple text-editing program with built in speech or the speech settings in the system preferences can be set to speak highlighted text when you use a keyboard command (i.e., control + T). Windows XP and VistaOS for Windows has the equivalent TTS with “Narrator” built into the system. Systems running Windows XP with Office 2003 can use built in TTS in MS Word®..

Free Text Readers on the Internet

Another free program that includes TTS is one that works with the Internet browser Firefox®. Click, Speak adds text to speech capability to the browser so that students can hear text spoken while they are on the web. Adobe Reader is a free download that reads many pdf documents. A pdf document is often the type of document downloaded from web sites. Many standard text readers cannot read them, however Adobe Reader, v. 7 or higher can read, although it has navigational and other limitations. Zamzar is a free online document converter. You can convert a pdf document into a document your text reader can read and highlight. PowerTalk is a free program that speaks the text in any presentation in Microsoft PowerPoint for Windows. Another free resource for anyone that uses MS Word 2003 on a Windows machine is WordTalk. It highlights each word as it is read, and it has a talking spellchecker and talking thesaurus.

Simply entering a keyword search for “free text readers” in your Internet browser should create a listing of available resources for you including ReadPlease, Natural Reader, Microsoft® Reader, iSpeak and more. Many of these programs offer versions with more options for a minimal fee.
WebAnywhere is a web-based free screen reader that can read whatever appears on the computer screen. WebAnywhere is a web-based, self-voicing web browser that enables web users to hear the text that is on web sites from almost any computer that can produce sound. It works in the browser and speech is generated remotely, then delivered to the computer, all without installing any software. This service resides on the University of Washington server.
Commercial Text Readers

There are many text readers that are available for purchase with pricing generally dependent on number of functions, capabilities and voice quality. Some of the lower cost programs that still offer good options include TextAloud and TextAssist® for Windows and AbleReader for Macintosh. A program by Premier Assistive Technology, PDF Equalizer reads PDF files, including text in graphs, fancy lettering, etc. without converting. It also includes a “notes” function and the ability to convert to MP3 format. Do consider the “lower cost” programs as many of them are very capable and may offer the supports your students need. They are oftentimes a good option for families.

Many school districts already have talking word processing programs such as Write:OutLoud® or IntelliTalk® for supporting struggling writers. While these programs are designed primarily for writing, any digital text can be copied and pasted into talking word processing programs and set to read sentences, paragraphs or the entire document.
When downloading e-text, you may see the term DAISY (Digital Accessible Information SYstem) as an option to select. DAISY is an international standard for formatting ebooks. There are six different types of DAISY books. Four of the types offer improved access and human voice delivery. They are navigable which enable readers to move from heading to heading, page to page, paragraph to paragraph, phrase to phrase and/or word to word. Pages can be bookmarked so that students can easily return to the last page read, search for words, go to a selected page and have the ability to speed up and slow down the audio playback without distorting the sound. DAISY books have both audio and text files but not all text readers are compatible with them. DAISY books can only be read with a DAISY reader or DAISY software which is embedded into many text or screen reading programs such as JAWS®, ReadPlease®, Kurzweil 3000™, WYNN™, TextHelp Read & Write Gold, AspireREADER™ and others. As DAISY books become the standard, expect to see most text reading software to be DAISY compatible.
Scanner with OCR and Text Reader
In order to use a text reader or even talking word processing software such as those listed above, the text must be in a digital format that text readers recognize as print. It can be from a CD, downloaded, scanned into the computer using a flat bed scanner or a copy machine with scanning capabilities or entered into a document by “traditional” methods. If the text is scanned into the computer, it must be converted by Optical Character Recognition (OCR) software before it can be “read” by any type of text or screen reader. OCR software recognizes print as text and inserts it into word processing programs or other text formats. Most scanners come with “light” versions of OCR software which will convert the text and allow you to manipulate it, copy it into a word processing or text document and use it with other programs. The full versions of OCR software such as OmniPage Pro, FineReader Pro or TextBridge Pro generally retain the format of the document that was scanned in, including graphs, tables, graphics/pictures and the specific formats found on worksheets or tests. It must be stated that the quality of the scanned text is largely dependent on the quality of the printed material. If you are scanning a print document that is a second-generation copy of the original, on low-grade paper, has faded ink or is of marginal quality, the scanned text will likely have numerous OCR errors. Whenever possible, scan documents from high quality, original sources.
“Scan and Read” programs are a different class of OCR software. These are sophisticated software programs that allow the student to create “user profiles” which adjusts the digital text to personalized reading settings. These programs easily allow the student to change the spacing between words and lines, add voice notes, typed notes and much more. Two examples of these are WYNN (What You Need Now) and Kurzweil 3000. Both of these programs include their own OCR software that converts scanned images into their own formatted text. Students can view the image on the computer as it looks on the page and have the text read to them. They can also add text, hear definitions, use powerful study tools, change the format of the text, select reading speeds, styles, voices and other customized settings. Additionally these programs will read the text on web sites.
Some slightly different programs, but within the same class are Read&Write GOLD and Premier Assistive Technology’s Accessibility Suite. These programs work with standard applications on your computer such as word processing, email, web browsers, and spreadsheet and media presentation software. Read&Write GOLD adds an additional toolbar to your programs with its own reading supports. The Accessibility Suite has a variety of programs that can provide reading supports for different documents. Both of these programs and Kurzweil 3000 also have mobile versions installed on flash drives. The Key to Access is a flash drive with the accessibility programs from Premier Assistive Technology Suite while Read&Write GOLD MOBILE includes is a portable version of Read&Write GOLD. Students who have a flash drive containing this software are able to access digital text and all of the other reading supports regardless of the school, home or community computer that they are using.
The last scan and read program to consider which is slightly different than those previously mentioned is the more economical Colligo Scan N Talk. The scanner is included as part of the program. It combines full OCR scanning options with accessibility features such as scanning to Braille, DAISY, Large Print, Audio, accessible pdf in addition to scanning to a word processing document. Scan N Talk uses AT&T Natural Voices™ and has some limited study supports.
All of these programs are worth considering if you need to scan large amounts of text for students. As with all assistive technology software, each program has unique strengths. It is well worth the time to explore each program with students to identify which one is the best match for students and district technology requirements. All of these programs have the ability to be trialed before purchase using vendor-provided demo CDs, trial downloads or through vendor grants (Premier Assistive Technology). Readers can also refer to product comparison matrices such as those developed by NCTI and CITEd’s Tech Matrix
Test Talker is a program from Freedom Scientific designed to assist with test taking, worksheet completion, and study of written materials by highlighting and reading the text. TestTalker maintains the integrity of the written test by not modifying the test, but providing the accommodation of a bimodal presentation of the written information. TestTalker supports true/false, multiple choice, fill-in, and extended answer tests. It includes a PDF converter so teachers can simply open an existing PDF file in TestTalker without needing to scan it to the computer.
It should be noted that all of the “scan and read” programs listed previously also have the capability of reading tests or worksheets and most can have text added to them by using specific features or scanning/conversion methods. However the OCR software may compromise the format of the printed page.
Text Reader with Study Skill Support
Research supporting the use of electronic study tools

Studies have found that proficient readers automatically use comprehension strategies to help them bring meaning to the text as they read. Struggling readers, on the other hand rarely use common comprehension strategies as they are reading, even though their understanding of the text is poor. “There is good evidence that struggling readers can improve reading comprehension skills by learning the strategies of proficient readers and putting them into practice” (Don Johnston, Inc., 2005). A study reported in the Journal of Special Education Technology by Lange, Phillips, Mulhern, & Wylie found that the following study tools—the speech synthesizer, spellchecker, electronic dictionary, and the homophone tool in Read & Write GOLD—all made a significant difference in reading comprehension for secondary students with literacy difficulties (Lange, Phillips, Mulhern & Wylie, 2006).

Many assistive reading programs have built in study skill support tools. Highlighting tools of different colors are available in supportive text readers, Read:OutLoud and Microsoft Reader and all of the scan and read programs (WYNN, Kurzweil 3000, Read&Write GOLD, Premier Assistive Technology Accessibility Suite and the mobile versions of both). Students or their support staff can highlight key vocabulary, main ideas, supporting details, important dates/places, organizational structure of the text, etc. with different colors from the toolbar. Those highlighted details can then be extracted into separate or combined study guides. Important passages a student needs to return to for clarification can be bookmarked so that the student can easily navigate to the desired page. Text notes can be added by teachers with explanatory information, to prompt a “think aloud”, ask a pre-reading question, or provide a summary of the passage. Students can use text notes or voice notes to record questions about text as they read or as the computer reads to them. Talking dictionaries provide explanations of key vocabulary often in the context of a sentence. Most of the programs offer either graphic organizers or outlining supports so that students can extract highlighted or bookmarked information. The extracted information can provide study guides, an outline for further research, vocabulary lists and other supportive information.
Hearing and seeing text read as it is by the computer may help the comprehension of many struggling readers, but providing and using study support tools increases student engagement with the text. Furthermore, the Don Johnston Inc. (2005) study showed when at-risk students learned and used effective strategies, those students generalized the strategies to other reading tasks and continued to use them after the instruction ended.
Student Specific Solutions
Using the Nonverbal Reading Approach to Teach Reading to Students with Severe Speech and Physical Impairments (SSPI)
Teaching reading to students who are unable to speak is possibly the most challenging of all instructional tasks. Reading is essentially a process where students decode letters and words or recognize familiar words by sight. They demonstrate those processes by speaking the words aloud. When the student cannot speak due to a severe physical disability it is very difficult both to identify current level of performance and to monitor progress. Consequently students with severe speech and physical impairments (SSPI) often experience significant reading and writing difficulties.
Many factors may contribute to the literacy difficulties of students with SSPI, including:

  • Lack of experience with literacy activities.

  • Difficulty holding or manipulating books and other materials.

  • Limited language experiences due to the lack of speech.

  • Reduced expectations for the development of literacy skills by both teachers and parents.

  • Restricted participation in “typical” literacy activities in school and home.

  • High levels of absenteeism from school due to health issues.


AAC-RERC is dedicated to the development of effective AAC, including a project researching effective literacy instruction for students using AAC. Summaries of their progress thus far, webcasts, Maximizing Literacy Skills of Individuals who Require AAC (Light), and publications are available on the website Heller, Fredrick, and Diggs (1999) demonstrated the effectiveness of the Nonverbal Reading Approach to teach reading to three students with severe speech and physical impairments (SSPI). The Nonverbal Reading Approach uses internal speech, diagnostic distractor arrays, and error analysis in conjunction with individualized adaptations including assistive technology. Part of that study will be summarized here.

Internal Speech–When students are unable to verbalize phonemes when sounding out a word, they can be taught to use internal speech (Bigge, 2001). Internal speech is the process of silently speaking to oneself.
Distractor Arrays–Because these students are not able to verbalize an answer, they must be provided with an array of choices from which to indicate an answer. Heller et al. (1999) describe the importance of the distractor array.
“A distractor array is a list of alternative choices provided to the student, either orally, or in writing (on paper, computer or AAC device). Distractor arrays are diagnostic when the alternative choices are carefully selected to include the correct answer and two or more additional items that can indicate a student’s misunderstanding. For example, if the student is learning the word, “ball” and the choices are ‘bill,” “ball,” “doll,” and “bat” and the student chooses “bill,” the error indicates that the student knows the first and last consonant, but not the vowel. If the student chooses the word “bat”, it indicates that the student knows the initial sound and/or consonant, but not the ending. If the student chooses “doll” it indicates that the student does not know the beginning sound or vowel (p. 7).
Error Analysis–The ability to analyze the student’s responses in order to determine the need for specific instruction is dependent upon a well-constructed distractor array.
A well-constructed diagnostic distractor array will target the errors the student has been found to make. These diagnostic distractor arrays will help determine if the student is really reading the word. Analysis of the errors will enable the teacher to determine the student’s specific problems and provide appropriate remediation, Poorly constructed distractor arrays provide little information and can give the impression that the student knows the word, when, in fact, the student does not. For example, if the student is learning the word, ‘ball” and the choices are “cat,” “ball,” “dog,” and “tree,” the selection of the word “ball” only tells us that the student can accurately select the correct first letter (b) of the word, but may not know the word “ball” from the word “big” (Heller, et al., 1999, p. 7).
Assistive Technology–A variety of assistive technologies may be needed to present the content and to allow the student to respond. Students with SSPI who already use voice output AAC devices may be able to utilize these devices to indicate their responses if the vocabulary is appropriate and the student’s level of competency with the device does not interfere. Some students may be able to respond when the material is presented on a computer. Others may need to have letters and words displayed on cards so that they use eye gaze to look at their choice. Some students with SSPI will be able to direct-select an answer by gazing at it, pointing to it or activating a computer or AAC device. Others will need to utilize scanning techniques. Scanning may be done with low-tech materials by having the teacher point to each item in the array and wait for the student to indicate his choice. It may also be accomplished with a single switch to select a choice on a computer or AAC device. It can be as simple as writing words, phrases, word endings, etc. on a small “wipe-off” board, note cards or even “sticky notes” so that the student can indicate their choice in their preferred manner. Low-tech options allow for the teacher to quickly monitor the student’s understanding and provide content “on the fly”. However there are times when it is necessary to program a student’s communication system with content vocabulary for increased participation, checking for understanding, book study or any other instructional reasons. To read more about using an alternative communication system, please refer to Chapter 3 – Assistive Technology for Communication in the manual.
Using the Nonverbal Reading approach

When teaching a word, the instructor first showed the word, then pointed to each letter or moved a card across the word revealing each letter as it is sounded out. The student was instructed to say the sound ‘in your head” while the teacher said the sound aloud. The student was then asked to “say the sound aloud” no matter what approximation of the sound the student was able to make. This helped ensure active participation on the part of the student.

Next, the student was instructed to “sound out the word in your head without stopping between sounds” as the instructor verbally blended the sounds aloud. Finally, the student was told to “say the word fast in your head.”
When the student was initially assessed on a word, the instructor showed the word and pointed to each letter (or used a card) as before. The same steps were followed when a word was first introduced, except that the instructor did not say the sounds or word aloud. Three or four choices were then provided, either written or oral, from which to choose the correct response. The diagnostic distractor array was carefully selected to provide possible alternatives that were close in pronunciation or visual appearance to the correct word to determine if the student really knew the word.
Student errors were documented and later analyzed to determine any patterns or types of errors being made. Identified errors led to additional instruction and practice or adaptations, depending upon the type of error. Diagnostic distractor arrays were specifically designed to include the words with letters that the student had previously confused so that it was possible to assess whether or not the student had learned the correct response.
This study indicated that the combination of internal speech, diagnostic distractor arrays, error analysis and assistive technology are an effective approach for teaching reading to students with SSPI. One of the keys to using this technique effectively is to attend carefully to the words and pictures used as distractors. They must be carefully selected to test the student’s ability to discriminate between very similar letters, sounds, letter combinations, or meanings. Highly dissimilar words or pictures would not be effective in assessing specific knowledge.
Silent reading using an augmentative or alternative communication system

The ability to read, specifically to read silently with comprehension, has a positive impact on school success, employability, independence, and autonomy, as well as providing a means for lifelong learning, entertainment, and introspection. For people who use augmentative and alternative communication (AAC), this ability carries each of these benefits, as well as enhanced face-to-face communication and the added ability to participate in asynchronous communication…Although many (AAC users) successfully learn to read words in isolation and understand text when someone reads it to them, estimates are that no more than 10% can read with comprehension above a second-grade level (Erickson, 2003).

Students who use AAC need to integrate and use all of the skills “typical readers” employ, but for the most part do so internally or silently. They must use their inner voice to “hold words” in their working memory long enough to process and understand the text. They must understand the structure of written language and have background knowledge about vocabulary and the topic. This is in addition to the physical aspects of reading such as coordinating eye movements involved in reading. Erickson (2003) says that it is especially important to build background knowledge with this group since so many of these students have limited experiences. Set a purpose for reading the passage so that the student understands clearly the reason for reading and the expectation of the task after the passage is read. She also stresses the importance of teaching AAC users to build meaning using the existing vocabulary already in their communication system rather than teach text specific vocabulary in isolation.

Solution Selection: Tools & Strategies
Use a Feature Match process to discuss and select those ideas, tools, and strategies that were generated during the solution brainstorming. Select those that best match the student, the environment and the reading tasks that need to be accomplished. Limit your selections to a reasonable number and prioritize them according to those that can be accomplished immediately, in a reasonable time period and those that will be considered at a later time or require additional or significant staff training.

Implementation Plan
After tools have been selected and prioritized, identify any trials or services that are needed including procurement of trial materials, team member(s) responsibilities, start date and length of trial, training needed and any other student/staff specific issues. Be certain to identify reading objectives and criteria of performance to determine the effectiveness of the trials.

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