A small-scale, longitudinal, phonological awareness training study with inner-city kindergarten children was conducted in four classrooms. The central goals of the study were the creation and evaluation of a phonological awareness training program and a preliminary look at the consequence of that training on basic phonological processes.Assessment of phonological awareness and basic phonological processes was carried out in the fall of the kindergarten year, and again in the spring following an 18 week training program which incorporated both auditory and articulatory techniques for fostering metaphonological development. Follow-up evaluation of promotion to first grade and of reading achievement took place a year later. The children in the two experimental classes receiving training had significantly greater gains in phonological awareness at the end of kindergarten, were significantly more likely to be promoted to first grade rather than to pre-one, and had a trend toward better reading skills in first grade than did the smaller group of children promoted to first grade from the control classes. In addition, there were some indications that development of phonological awareness was accompanied by changes in the underlying phonological system as well. Here we focus on the rationale and implementation of our training program and discuss the implications of the findings for a potential large-scale study.

Although weaknesses in metaphonological skills are well-documented in poor readers, prior studies have yielded inconsistent findings as to whether less-skilled readers also have deficits in the more primary phonological processes entailed in verbal working memory and speech production tasks. The present study was designed to examine this issue by comparing less-skilled third-graders readers (n=30) with younger children at the same reading level (n=30) and with more-skilled agemates (n=30) on a variety of tasks that require phonological processing (i.e., three "verbal memory" tasks [word span, span with concurrent processing, pseudoword imitation] and three "speech production" tasks [word-pair repetition, tongue twisters, rapid naming]). The results were striking: the less-skilled third-grade readers had significantly lower accuracy scores than both their agemates and the younger normal readers on the word span, pseudoword imitation, word-pair repetition, and tongue twister tasks. Measures of accuracy were more related to reading ability than were measures of speed. Performance on a pseudoword imitation task was the variable most strongly linked to reading achievement.

Potential side effects were assessed on a linear analogue scale. The scale was explained to patients, who completed it 24 hours after starting cytotoxic chemotherapy and returned it to the researchers. Patients rated their nausea, vomiting, and 18 other potential side effects of chemotherapy or the antiemetics on a 100 mm line. Results were analysed with the Mann-Whitney U test2 as the unpaired data did not conform to a normal distribution. Confidence intervals were calculated with the method of Campbell and Gardner.3 Low scores on the assessment scales indicated little toxicity and high scores severe side effects.The table shows the ranked scores for nausea in the two groups, the difference being significant (p=0 001). As highly emetogenic cytotoxic drugs, such as cisplatin, were not used a high proportion of patients (40%) reported no vomiting. Despite this most patients with severe vomiting were in the placebo group. Median scores were 1 for the active group and 14 5 for the placebo group. The estimated difference was 9 99 (95% confidence interval 0 to 14 9; p=0 02).

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