Izzo, M., Yurick, A., & McArrell, B. (2009). Supported eText: Effects of text-to-speech on access and achievement for high school students with disabilities . Journal of Special Education Technology , 24 (3), 9–20. https://www.isetcec.org/journal-of-special-education-technology-jset/

Assistive technology (AT), specifically text-to-speech software for presenting reading passages, was investigated. Accessibility features of the open-source AT program called "CLiCk, Speak" included "screen magnification, text smoothing and sharpening, focus and caret tracking, color enhancement, and image smoothing" (p. 12).

Seven (7) students with disabilities from a small city high school in a midwestern state (U.S.) participated. All students were White and their teacher was a White woman with 12 years of teaching experience. All students had below-grade-level reading skills. Each student's learning profile was described, including that three had cognitive disabilities, one had autism, one had emotional disabilities, one had learning disabilities, and one had a traumatic brain injury with memory impairments.

The AIMSweb Maze assessment, using Cloze tasks offering multiple-choice options throughout text passages, was used to measure general reading ability into categories of benchmark, strategic, or intensive—indicating increasing degrees of support that they need. Students were engaged in the EnvisionIT online transition curriculum focusing on information literacy—integrating reading, writing, and technology to help students explore careers, complete age-appropriate transition assessments, write measurable goals, and develop self-directed transition plans. Unit quizzes tested student learning of the curricular content with 10 items; in addition, each unit quiz incorporated one reading passage and a separate 10-item comprehension section. unit quizzes on the EnvisionIT curriculum measured student comprehension of material. In total, 20 quiz scores were analyzed for each student, with two quizzes per module, one presented at the midpoint of each unit, and one comprehensive quiz at the end of each unit. Consequently, separate scoring and reporting was done for (a) learning of the content concepts, and (b) comprehension of the quiz reading passages.

Participants demonstrated, through group mean differences, increased content mastery presented by text-to-speech (TTS) assistive technology over the unaccommodated text condition, with large effect sizes. Five participants made significant individual score increases with the use of text-to-speech, and two participants' individual scores declined slightly with the use of text-to-speech. Participant performance on the reading comprehension items for the tests' text passages indicated significant benefits when using text-to-speech, both for the overall group means—without TTS, 4.85; with TTS, 6.98—as well as for individual participant scores, with increases ranging from 0.67 to 4.67; only one participant averaged the same comprehension score (mean of 6.5) with and without TTS.