2.1. Study Design and Population
This was an applied semi-experimental study (pre-test, post-test, and follow-up) with the test and control groups which is conducted at the Roshan Mehr, and Sayad Shirazi schools of Tehran, Iran). Informed consent was obtained from all participants that included in this study. Accumulation of Samples was started from February 2015 to February 2016. The age range was 5 to 12 years.
In order to select the subjects, children with special needs were selected among two schools after announcing a partnership. Among these schools, after specifying the slow-paced students with Down syndrome and matching, as well as analyses of intelligence for variables of IQ (from 50 to 75), and social class (inserted in the file of students) and talking with their families, 20 people were selected randomly which 10 people were as control group and 10 people were as test group. In each school, 5 students were assigned in test group and 5 people in control group that in total, the sample size was 20 samples (10 samples for girls and 10 for boys). The test group was participated in 30 sessions. Each session was held in one day and two time limits by family. Each period of time was 15 minutes till 30 minutes, according to the conditions and the manner of cooperation of the child. Thirty-first sessions was a post-test, and follow-up was performed during a month and a half later.
2.2. Ethical Approval
The Islamic AZAD University of Tehran ethics and scientific committees has been approved the study protocol (REC.1393.9454).
The inclusion criteria were as follows:
1) Slow-paced students with Down syndrome that is studying at the age of preschool and school.
2) Semantic understand of words (approximately 500 words) using the Peabody test.
3) The ability to select and sort using advanced technology of mobile phone and tablets.
4) IQ = 50 - 75 with Wechsler intelligence test by an exceptional Children Psychologist.
5) The absence of severe hearing and vision problems (which diagnosed by opticians and audiologists)
6) The family consent and its cooperation in research projects.
The exclusion criteria were as follows:
1) IQ < 50
2) Severe hearing and vision problems
3) Low family cooperation
4) Age less than 5 years old or more than 12 years old.
2.3. Research Tools
The Individual questionnaire including demographic data (name, age in terms of months, bilingualism, social, family, and education conditions, sex, etc.); it was used to obtain information about social, economic, and educational fields in order to match the samples in the test and control groups (
3). In the present study for IQ and also in order to match slow-paced students the Wechsler intelligence scale for children - revised (WISC-R) was adopted and was standardized by Shahim for children. These tests were performed individually, in standard conditions, according to the instructions ( 4). A checklist was in six categories, including animals, fruit, furniture, body parts, clothing and jobs which was prepared and used. Both in the process of software designing and sample matching that condition for presence in the research understanding the meaning of 50 words, not its expression ( 5). We used the Test of language development (TOLD) for a two-dimensional pattern that in total has the nine subtests, which six subtests of them are related to the semantics and syntax; and three subtests are related to reading ( 6). 2.4. Statistical Analysis
The distinction of the word, phonological analysis, reading skill and production of word were compared in two arms of this study using an analysis of covariance, and α. α more than 0.001 was considered significant. The Bonferroni follow-up test was used in order to analyze the repeated measurements. The significant α was more than 0.001.
2.5. A Researcher-Made Educational Application for Reading
This software has been made by the researcher, with the aim of new training technology along with advances in the field of children’s reading and language skills for children with Down syndrome. This software can be used for Android mobile phone systems and tablets. The software also has been created by utilizing technology, psychological affairs, and speech science, and it has been tried to consider many aspects by taking advantage of the most frequency routine words among children, as well as the Whole-word reading method along with an animation of everyday behaviors and familiar images in their life (real images of family members) and placement in the family. The children can take advantage of this software.
The software has two areas; education of words, which pursued the different and regular categories; and education of verbs, which included three categories: sense, past, and imperative verbs. On the other hand, it includes two-word and three-word phrases and pronouns. Furthermore, passing through the steps is subject to follow it and it has been designed in two models for word games.
2.6. The Structure of the Program Implemented
This program has been implemented in the two sections: the training and game that each will be described in detail.
In order to implement program, each of sections after breaking down into more minor parts, were given to companies of Gonbad Kabud (for graphical design) and Aria Gostar (computer programming).
2.7. Graphical Design
In all parts of the program, a required graphical component (on the basis of psychological projection given by the researcher) was conducted by aforementioned company. The graphical components implemented was included: the main character in the program (boy and girl with faces matched with Down syndrome sufferers), pictures and animations are related to the program concepts and graphical components used in the program that each of pictures and concepts has closest conditions with living of students.
At the first, after providing sample pictures of children with Down syndrome to graphic designers of the project, male and female characters were designed. After the initial implementation, and applying the necessary changes, final sample was prepared. After the initial implementation of the program by the graphic company, and after examination by the researcher and presenting to the pilot group, necessary changes in components and concepts contained in the program was performed in order to achieve the desired sample.
2.8. Computer Design
In order to conduct the computer program that can be used in the Android operating system, first, based on the studies and design provided by researcher the overall program logic was given to the Psychology department, and was implemented; then, after examination, the necessary changes were applied. After preparation of overall configuration of the program, all required details were anticipated.
After completion of the design on paper, and after presentation and discussion of the plan details, the computer implementation was performed by the ARIA Gostar Co. The implementation process of this program was planned in four phases: initial, middle, final, and support.
2.9. Examples of the Implemented Program Levels
2.9.1. Review and Practice
The first level includes a review and practice, writing shape of words was shown 5 times for the child and the word has been read with sound. At this level, there is no expectation for a response from child, and it is performed in order to introduce the written form of words.
The second level was accordance, that means the written shape or image of the word is shown for the child and he or she must accord it with written and visual form. Accordance the word has two parts: 1) text accordance-word form; 2) word form-text.
In the level selection, word can be read and child must select written shape in accordance with the read word.
2.9.4. To read the Word Aloud
The words are that child reads them loudly in response to the relevant text shape, based on the word detection pattern and not read letter by letter.
2.9.5. Calling the Image
The words are that child activates the relevant visual representation in response to the relevant image and call the image name.
It should be noted the next steps in terms of sentence length (verbs, two- word, and three-word, etc.) were implemented animationally and used in training.
Below there is a picture of this area