Cut-off point, sensitivity and specificity for screening the reading fluency in children.
Hugo Cogo-Moreira, Giovanna Lima Molinari, Carolina Alves Ferreira de Carvalho and 3 others
PMID 37283398WHAT IT FOUND
Reading speed alone can screen for comprehension issues in Portuguese-speaking children.
The study established cut-offs: 65 words per minute for 3rd graders, 70 for 4th, and 91 for 5th. Speeds below these suggest comprehension risk, though accuracy was equally effective.
Key findings
01Cut-off values for oral reading rate to ensure literal comprehension were established at 65, 70, and 91 words per minute for 3rd, 4th, and 5th grades respectively.
02Reading rate and accuracy produced similar diagnostic accuracy (area under ROC curve > 0.80), but rate was chosen for ease of clinical application.
03The cut-off value for 2nd graders (47.01 wpm) was statistically estimated, not observed, and is recommended primarily for research rather than clinical screening.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The 'gold standard' for classification was teacher opinion, which the authors admit may be less sensitive for older children, potentially affecting the accuracy of the cut-offs. The study population was Brazilian Portuguese-speaking children, so these cut-offs may not apply to other languages or educational contexts. The cut-off for 2nd graders was estimated mathematically rather than measured directly, and the authors explicitly state it is more suitable for research than clinical screening. The results are tied to specific narrative texts; using different texts may yield different fluency rates. The study did not include children with diagnosed learning disorders, only those with teacher-reported difficulties.
Declared interests
Funded by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP). No conflicts of interest declared.
The easy way to misread this
Do not apply these cut-off values to children reading different texts or in different languages. The authors explicitly recommend using the same narrative texts from the study, as text complexity significantly impacts reading rate.