Spiel, C. F., Mixon, C. S., Holdaway, A. S., Evans, S. W., Harrison, J. R., Zoromski, A. K., & Yost, J. S. (2016). Is reading tests aloud an accommodation for youth with or at risk for ADHD ? Remedial and Special Education , 37 (2), 101–112. https://doi.org/10.1177/0741932515619929

The oral delivery assessment accommodation was investigated. Student participants were presented both control and experimental conditions, with the latter being that the test administrators read instructions and test items aloud to small groups of four or five participants. The control condition was that the test administrators passed tests out to groups of about 10 students, read the directions aloud, then the students completed the test items in silence.

Thirty-six students in grades 4, 5, 6, and 7 (ages 9–14) from elementary and middle schools in a school district in Ohio (U.S.) were recruited for a one-week summer camp program that had art, recreation, and academic components. Almost half (n=16) of the students had either previously been diagnosed with attention-deficit hyperactivity disorder (ADHD; n=11), or been determined to be at risk for ADHD (n=5); sub-type information and concurrent mental health and learning disabilities information were also provided for these students. The other twenty students had no ADHD diagnoses, and only two of them had other disabilities (learning disabilities). Students gender, race/ethnicity, and family income were also reported.

As part of the summer camp recruitment process, students' parents reported students' difficulties through a few diagnostic measures—Wechsler Abbreviated Scale of Intelligence-Second Edition (WASI-II), Wechsler Individualized Achievement Test-Third Edition (WIAT-II), Disruptive Behavior Disorder Rating Scale-Parent Version (DBD), and Impairment Rating Scale-Parent Version (IRS)—and participated in the Children's Interview for Psychiatric Syndromes-Parent Version (P-ChIPS). The summer camp's academic component provided science instruction segments of 45 minutes per day, and then student participants completed daily 20-item tests, with multiple-choice and short-answer items, in a 10-minute period; test scores of percent correctly answered were documented. Each student's scores were compared across condition, and group comparisons between students with and without ADHD were completed, including their WIAT-III Word Reading scores as a covariate.

Student participants with ADHD, on average, scored significantly higher when provided in-person oral delivery and small group accommodations in comparison with reading the science test items silently to themselves. Students without ADHD on average scored essentially the same with and without the accommodation. The group of participants with ADHD scored significantly lower than the participants without ADHD group in the silent testing condition, but both groups did not score significantly differently when receiving oral delivery in small groups. Individual comparisons of students with ADHD in both testing conditions indicated that only one student with ADHD scored lower with oral delivery than with no accommodation, and the other 15 scored higher with oral delivery than with no accommodation. Individual comparisons of students without ADHD yielded that 12 scored lower with oral delivery (and small group), and eight scored higher with oral delivery (and small group), compared with the silent reading large group testing condition. An additional exploratory analysis was performed to examine whether all students who scored lower than average on testing in general, and whether they improved with oral delivery, or if students with ADHD received a differential boost from the accommodated testing condition. The results indicated that all low-scoring students benefited, and that students with ADHD benefited more but not at the level of statistical significance. The researchers concluded that two factors might have benefited students with ADHD when receiving the accommodated testing condition: the decreased number of test-takers provided a "more controlled atmosphere" that decreased distractions, and the engagement of students with ADHD in the test items with both visual and auditory senses increased sustained attention and decreased test response errors. Limitations of the study were reported, and future research directions were suggested.