Small-Group Reading Intervention Shows Differential Gains in ADHD, BIF, Dyslexia

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Frontiers in Medicine Published April 23, 2026 Medically reviewed May 25, 2026 DOI ↗ By Dr. Sofia Müller, MD · Lifespan & Whole-Person Care

Key Takeaway

Consider that ADHD group showed greater reading gains than BIF or at-risk dyslexia in this low-resource observational study.

In a low-resource, out-of-school setting, researchers conducted a retrospective cohort study of 90 children in third grade with neurodevelopmental disorders, including ADHD, borderline intellectual functioning (BIF), or at-risk for dyslexia (arDYS). The Less Intensive Response to Intervention Tier 2 (LIRTI2) program delivered 18 weekly, two-hour sessions combining explicit phonological awareness and fluency-focused instruction using playful, low-cost materials in small groups stratified by reading proficiency. Baseline reading measures served as the comparator.

After adjusting for baseline reading speed and schooling, post-intervention reading speed showed a significant diagnostic effect (ANCOVA F(2,85) = 4.345). The ADHD group (n=37) demonstrated significantly higher reading speed than the BIF group (n=14; p=0.034) and the arDYS group (n=39; p=0.047). For reading comprehension, the association between clinical group and comprehension level became significant post-intervention (χ2(4, N=90) = 14.75, p=0.005), with more children with ADHD achieving high comprehension levels.

Safety and tolerability were not reported, and there was no follow-up. Key limitations include the retrospective, service-based design, potential selection bias, and lack of long-term data. The practice relevance is that LIRTI2 is an out-of-school, small-group intervention with potential scalability in low-resource settings where access to services is limited. However, findings show association, not causation, and generalizability beyond this context is uncertain.

Study Details

Study typeCohort

EvidenceLevel 3

PublishedApr 2026

View Original Abstract ↓

IntroductionReading proficiency is a foundational skill. Failure to achieve reading competence constitutes a global educational and public health challenge. This burden is especially high among children with neurodevelopmental conditions. Despite the availability of evidence-based frameworks, such as Response to Intervention (RTI), a lack of scalable, context-sensitive models remains for supporting struggling readers in low-resource environments. Building on this context, this study describes the Less Intensive Response to Intervention Tier 2 (LIRTI2). We hypothesize that the LIRTI2 will improve reading speed and comprehension in children with Attention-Deficit/Hyperactivity Disorder (ADHD), Borderline Intellectual Functioning (BIF), and those at risk for Dyslexia (arDYS). We also predict differential effectiveness of the intervention across neurodevelopmental profiles.MethodsThis retrospective, service-based study included 90 children (median age = 9 years, 3rd grade). Participants (ADHD = 37, BIF = 14, and arDYS = 39) completed 18 weekly, two-hour sessions per week that combined explicit phonological awareness and fluency-focused instruction with playful, low-cost materials. For the intervention, students were divided into small groups based on reading proficiency. Reading speed (words per minute) and reading comprehension (literal questions) were assessed before and after the intervention. The groups were similar in age, school grade, and sex distribution.ResultsA significant diagnostic effect was found on post-intervention reading speed, after adjusting for baseline reading speed and schooling [ANCOVA F(2,85) = 4.345, p > 0.01]. The ADHD group demonstrated significantly higher reading speed than BIF (p = 0.034) and arDYS (p = 0.047), whereas the BIF–arDYS comparison was not significant. While clinical group was not associated with reading comprehension level (low, medium, high) before LIRTI2, this association became significant after the intervention [χ2(4, N = 90) = 14.75, p = 0.005]. Adjusted standardized residuals indicated that more children with ADHD achieved “high” comprehension levels.DiscussionLIRTI2 is an out-of-school, small-group intervention with potential scalability in low-resource settings where access to services is limited. Reading fluency and comprehension improved following the intervention, with larger gains in children with ADHD than in those with BIF or arDYS. Future studies with follow-up are needed to confirm which learner profiles benefit most and to determine the intervention’s broader academic impact.