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LLM - Digital Humanities 16

ERROR: type should be string, got "https://doi.org/10.1007/s10648-022-09671-8\nEducational Psychology Review (2022) 34:1709–1737 https://doi.org/10.1007/s10648-022-09671-8\nEducational Psychology Review (2022) 34:1709–1737 INTERVENTION STUDY Effects of 8 Weeks with Embodied Learning on 5–6‑Year‑Old \nDanish Children’s Pre‑reading Skills and Word Reading \nSkills: the PLAYMORE Project, DK Linn Damsgaard1   · Anne‑Mette Veber Nielsen2   · Anne Kær Gejl3   · \nAnne Sofie Bøgh Malling1   · Søren Kildahl Jensen1   · Jacob Wienecke1,4 Linn Damsgaard1   · Anne‑Mette Veber Nielsen2   · Anne Kær Gejl3   · \nAnne Sofie Bøgh Malling1   · Søren Kildahl Jensen1   · Jacob Wienecke1,4 Accepted: 17 March 2022 /\n© The Author(s) 2022\nPublished online: 14 April 2022 *\t Linn Damsgaard \n\t\nLinn@nexs.ku.dk\n1\t\nDepartment of Nutrition Exercise and Sports, University of Copenhagen, Copenhagen, Denmark\n2\t\nThe National Centre for Reading, University College Copenhagen, Copenhagen, Denmark\n3\t\nDepartment of Sports Science and Clinical Biomechanics, University of Southern Denmark, \nOdense, Denmark\n4\t\nDepartment of Sport and Social Sciences, Norwegian School of Sport Sciences, Oslo, Norway 1\t\nDepartment of Nutrition Exercise and Sports, University of Copenhagen, Copenhagen, Denmark\n2\t\nThe National Centre for Reading, University College Copenhagen, Copenhagen, Denmark\n3\t\nDepartment of Sports Science and Clinical Biomechanics, University of Southern Denmark, \nOdense, Denmark\n4\t\nDepartment of Sport and Social Sciences, Norwegian School of Sport Sciences, Oslo, Norway Introduction Reading is a complex unique human skill, which serves an essential role in mod-\nern society. Poor spelling and reading skills in children and adolescents have been \nassociated with poor academic achievement (Savolainen et al., 2008; Smart et al., \n2017; Willcutt et al., 2007), school dropout (Daniel et al., 2006; McGee et al., \n2002), and lower occupational status in adulthood (Savolainen et al., 2008). The \nacquisition and development of competent reading skills in childhood are there-\nfore critical to functioning and well-being later in life. g\ng\nLearning to read in alphabetic orthographies requires children to learn and \nremember the connections between phonemes of spoken words and graphemes \nof written words (letter-sound knowledge) as these connections are essential for \nthe decoding of unfamiliar words (Byrne & Fielding-Barnsley, 1989). Phoneme \nawareness and letter knowledge measured before the outset of formal reading \ninstruction are unique predictors of later reading and spelling abilities (Caravolas \net al., 2012; Furnes & Samuelsson, 2009; Hulme et al., 2012; Kirby et al., 2008; \nMelby-Lervåg et al., 2012; Schatschneider et al., 2004). Danish may be particu-\nlarly challenging for learners as it has an irregular orthography including standard \nand conditional pronunciations of letters with some similarities to English (Elbro, \n2014; Juul & Sigurdsson, 2005). Computing phoneme-grapheme consistencies in \naccordance with Kessler and Treiman (2001) (Kessler & Treiman, 2001), Juul \n(2008a, 2008b) reported consistencies (on a scale from 0 to 1) of 0.672 for Dan-\nish vowels and 0.750 for consonants (Juul, 2008a). These coefficients imply that \nthe correct spelling of a Danish phoneme is often relatively difficult to predict. Kessler and Treiman (2001) found an even lower vowel consistency of 0.529 for \nEnglish (Kessler & Treiman, 2001). Integrating movement in school teaching sessions has previously proven to \nbe an effective strategy to support learning (Mavilidi et al., 2020). Therefore, it \ncould potentially facilitate the attainment of reading skills. This approach can be \nimplemented in many ways, for instance, by increasing children’s physical activ-\nity levels leading to the release of neurotransmitters that are beneficial to memory \nformation (Skriver et al., 2014). The majority of studies adopting this approach \nreport a positive influence on academic performance, as shown in several reviews \n(Alvarez-Bueno et al., 2017; Daly-Smith et al., 2018; Donnelly et al., 2016; Nor-\nris et al., 2015; Singh et al., 2019). Abstract The aim of this study was to investigate the effects of embodied learning on chil-\ndren’s pre-reading and word reading skills. We conducted a three-armed randomized \ncontrolled trial including two intervention groups and one control group. One hun-\ndred forty-nine children from grade 0 (5–6 years old) who had just started school \nwere recruited from 10 different classes from four elementary schools. Within each \nclass, children were randomly assigned to receive teaching of letter-sound couplings \nand word decoding either with whole-body movements (WM), hand movements \n(HM), or no movements (CON) over an 8-week period. Children were evaluated \non pre-reading, word reading, and motor skills before (T1), immediately after (T2), \nand after 17–22 weeks of retention period (T3) following the intervention. Between-\ngroup analysis showed a significant improvement in children’s ability to name letter-\nsounds correctly from T1 to T2 (p < 0.001) and from T1 to T3 (p < 0.05) for WM \ncompared to CON. HM and WM improved significantly in naming conditional let-\nter-sounds from T1 to T2 (p < 0.01, p < 0.01) compared to CON and from T1 to T3 \nfor the HM group compared to CON (p < 0.05). We did not find an effect on word \nreading or a correlation between motor skill performance and reading. Results from \nthe present study suggest that there are beneficial effects of using whole-body move-\nments for children. Hand motor movements indeed also had a performance effect \non letter-sound knowledge; however, the whole-body movements had longer-lasting \neffects. We do not see an effect on whole word reading. *\t Linn Damsgaard \n\t\nLinn@nexs.ku.dk 012341 456789)\n3 Educational Psychology Review (2022) 34:1709–1737 1710 Introduction g\nAnother way to apply movement in teaching is by embodied learning, where \nthe movements support learning without a significant increase in the level of \nphysical activity or metabolism. The theory of embodied cognition suggests that \ncognitive processes are mental representations derived from our senses (e.g., \nvision, hearing, kinesthetic, and tactile) and are integrated into the sensorimo-\ntor system (Lawrence W. Barsalou, 1999a, 1999b; Engelkamp & Zimmer, 1989; \nGlenberg, 2010; Macedonia, 2019). According to Barsalou, humans use their sen-\nsory neural structures to create multisensory representations of their environment \nand thereby are able to reuse those brain structures that are active during percep-\ntion when mentally imagining an action or object (L. W. Barsalou, 1999a, 1999b; 1 3 3 Educational Psychology Review (2022) 34:1709–1737 1711 Lawrence W. Barsalou, 2008). Recruitment of the motor system seems to sup-\nport cognitive processes when learning new complex tasks (Geary, 2008; Paas & \nSweller, 2012). Thereby, bodily movement combined with academic learning will \nhave the potential to enhance the ability to understand and provide better recall \nof the academic knowledge. Movements that are meaningfully integrated into the \nlearning task have been recognized as especially beneficial (Skulmowski & Rey, \n2018). Research has demonstrated that motor actions can enhance memory for-\nmation for specific information through gestures as well as observed enactment \n(Engelkamp & Zimmer, 1989; Madan & Singhal, 2012). Furthermore, observing \ngestures explaining or related to the learning task elicits stronger decoding than \nlistening to the learning task alone (Engelkamp & Zimmer, 1989). Based on this knowledge, educational research on embodied learning has inves-\ntigated teaching models where the learning task is supported by, e.g., congruent \nbodily movements instead of only listening or observing in order to reinforce the \nlearning process (Macedonia, 2019; Skulmowski & Rey, 2018). In fact, embodied \nlearning does not necessarily involve bodily engagement of the learner’s own body; \nin addition to, e.g., gesturing and enactment, learning activities can also include \nwatching animations or other seated interactions related to the content (Agostinho \net al., 2015; Dubé & McEwen, 2015; Pouw et al., 2016). In a recent review by Skul-\nmowski and Rey (2018), different types of embodied learning models were dis-\ncussed with an educational focus, and a 2 × 2 grid taxonomy was designed with the \nfollowing dimensions: task integration (incidental vs integrated) and bodily engage-\nment (low vs high). Introduction According to Skulmowski and Rey, congruence between the \nlearning task and bodily engagement is the primary key to enhanced performance, \nwhile the level of bodily engagement may have a lesser degree of influence (Skul-\nmowski & Rey, 2018). A study by Wellsby and Pexman (2019) investigated whether \nthe degree of sensorimotor experience modulates 5-year-old children’s word learn-\ning (Wellsby & Pexman, 2019). Results indicated that there was no effect in learn-\ning condition on children’s word recognition accuracy. The authors explain this by \nthe lack of congruency between sensorimotor experience children received and the \ninformation to be learned. This empathizes the importance of congruency between \nlearning task and embodiment. However, high bodily engagement has not only been \nlinked to learning gains but also the risk of cognitive overload (e.g., Ruiter et al., \n2015), and some researchers suggest thereby a medium degree of interactivity to be \nbest suited for increasing learning outcome (Kalet et al., 2012). Previous studies on children of 6–9 years old have shown that in both second lan-\nguage learning (Macedonia & Knösche, 2011; Mavilidi et al., 2015), mathematics \n(Beck et al., 2016; Goldin-Meadow et al., 1999), and letter recognition (Damsgaard \net al., 2020), learning strategies integrating congruent bodily movements advanced \nacademic performance (Macedonia, 2019). Mavilidi et al. (2015) demonstrated that \nchildren 4–5 years of age performing whole-body movements while learning new \nforeign words reached higher learning outcomes compared to children who used \ngestures or no bodily movements. This finding implies that whole-body movements \nmay be more beneficial for word learning compared to part-body movements. How-\never, in an acute study with 7-year-olds by Damsgaard and colleagues, a 10-min fine \nmotor–enriched training (i.e., using hands and fingers) for distinguishing the letters 1 3 3 3 Educational Psychology Review (2022) 34:1709–1737 1712 b and d had a greater positive effect compared to gross motor-enriched training (i.e., \nusing arms) and training without bodily movements (Damsgaard et al., 2020). Both \nstudies suggest that the effect of integrated bodily movements may depend on the \nmotor modality used. Other studies on the acquisition and development of reading \nand spelling skills have investigated bodily integration such as embodying letters \n(Botha & Africa, 2020) and walking the outline of a letter (Bara & Bonneton-Botté, \n2017). Introduction The study by Botha and Africa (2020) investigated the effect of a perceptual-\nmotor intervention for 6–7-year-old children delivered for 60 min twice a week over \na period of 12 weeks. The study found that the perceptual-motor intervention was \neffective and reported a significant improvement in reading and spelling skills. Bara \nand Bonneton-Botté (2017) investigated the impact of a visuomotor intervention of \n6 weeks, with six 45-min sessions for 5-year-olds’ cursive letter knowledge. They \nfound a greater improvement in letter recognition following the visuomotor inter-\nvention, compared to a visual-only intervention. Yet, none of these studies has compared whole-body movements and part-body \nmovements with conventional non-motor teaching methods within the research area \nfocusing on early reading development. Thereby, our intervention aims to clarify the \neffects of two embodied interventions for reading-related skills using movements \nwith different motor modalities in close connection to the academic content. We \ndesigned a longitudinal study with an 8-week phonics intervention delivered three \ntimes a week for 30 min to investigate the effect of bodily engagement (whole-body \nand hand motor) on pre-reading and word reading skills. The outcomes of the inter-\nventions were compared to conventional, non-motor teaching normally implemented \nin schools. The study addresses the following three questions: 1)\t Does teaching condition (whole-body, hand motor, and non-motor teaching) \nresult in significant group differences in letter-sound knowledge and reading of \ntrained words?if 1)\t Does teaching condition (whole-body, hand motor, and non-motor teaching) \nresult in significant group differences in letter-sound knowledge and reading of \ntrained words? 1)\t Does teaching condition (whole-body, hand motor, and non-motor teaching) \nresult in significant group differences in letter-sound knowledge and reading of \ntrained words? More specifically, we investigated if teaching with different degrees of motor \nmodality would affect children’s knowledge of letter-sound connections trained \nin the intervention (divided into standard and conditional sounds) and reading \ntrained words immediately post-intervention and at 17–22 weeks after the inter-\nvention (retention test). We tested the hypothesis that children in the intervention \ngroups connecting hand motor or whole-body movements and letter-sounds would \nhave the greatest direct training effect in letter-sound connections (standard and \nconditional sounds) and word reading. result in significant group differences in letter-sound knowledge and reading of \ntrained words? 3)\t Is there a significant correlation between children’s baseline motor skills and \nchildren’s reading-related skills post-intervention and at retention test? 3)\t Is there a significant correlation between children’s baseline motor skills and \nchildren’s reading-related skills post-intervention and at retention test? We aimed to clarify the role of motor skills in relation to reading-related skills. We employed two motor skill measures and tested the hypothesis that motor skill \nability was associated with children’s pre-reading and word reading skills. Further-\nmore, we asked whether children’s motor skills could be associated with the preva-\nlence of performing embodied learning exercises when producing letter-sounds. Study Design and Participants The present study was conducted with 5–6-year-old children who had just started \nschool (grade 0) and were recruited from 10 different classes from four elementary \nschools in the Copenhagen area, Denmark. At the beginning of grade 0, students are \nusually able to identify at least half of the letters of the alphabet (Juul, 2008b), but \nonly few students will be able to read words (Juul, 2008b; Poulsen & Jensen, 2015). One hundred eighty-three children were included in the study after obtaining written \nconsent from parents. Fourteen children were excluded due to less than 90% pres-\nence of total lessons from the intervention, eight children with neural developmental \nconditions were excluded, and one child withdrew from the study, which in the end \nresulted in 149 participating children (76 girls, 73 boys, mean age ± SD = 6.2 ± 0.4) \n(see Table 2 for demographic characteristics by intervention group). The study was approved by the local Ethical Committee at University of Copen-\nhagen, Denmark (protocol: 504–0032/18–5000), registered in ClinicalTrials.gov \n(NCT04618822), and carried out in accordance with the Helsinki Declaration II. The present study is described in detail elsewhere (Gejl et al., 2021), and only meth-\nods pertinent to this study are included here. Introduction More specifically, we investigated if teaching with different degrees of motor \nmodality would affect children’s knowledge of letter-sound connections trained \nin the intervention (divided into standard and conditional sounds) and reading \ntrained words immediately post-intervention and at 17–22 weeks after the inter-\nvention (retention test). We tested the hypothesis that children in the intervention \ngroups connecting hand motor or whole-body movements and letter-sounds would \nhave the greatest direct training effect in letter-sound connections (standard and \nconditional sounds) and word reading. 2)\t Does teaching condition (whole-body, hand motor, and non-motor teaching) \nresult in significant group differences in word reading? Specifically, we tested if the interventions would affect children’s ability to \nread words in a standardized test (far transfer effect) and their ability to read short \nwords that resembled the words trained during the intervention (near transfer \neffect). We tested the hypothesis that children in the intervention groups con-\nnecting hand motor or whole-body movements and letter-sounds would have the \ngreatest transfer effect in word reading. 1 3 Educational Psychology Review (2022) 34:1709–1737 1713 Intervention The study is a three-armed randomized controlled trial including two intervention \ngroups and one control group. One hundred eighty-three participating children were \nindividually randomly assigned before baseline assessment to receive either teach-\ning activities with whole-body movements (WM), hand movements (HM), or a con-\ntrol group with no movements besides handwriting (CON) over an 8-week period. Within each class, six participants were allocated to WH and six participants to HM, \nand the remaining participants were constituted to CON in an approximate 1:1:2 \nfashion. The intervention sessions were delivered during the same time slot but in \nseparate classrooms for each group. In addition, the control group learning activ-\nities were incorporated into the school curriculum for the period of the interven-\ntion. This meant that all children in the participating classes completed the control 1 3 Educational Psychology Review (2022) 34:1709–1737 1714 group activities, but only the children whose parents provided written consent were \nincluded in the control group. During the 8-week intervention period, three sessions of 30-min duration were \ncompleted each week, counting 24 sessions in total. Three classes were delayed \n1  week, and one of the three classes only performed 23 of 24 sessions due to \nCOVID-19. The learning activities focused on the acquisition of letterforms, letter-\nsound correspondences, and reading and spelling short words. Thus, word meaning \nwas not a primary focus in this intervention. In all three groups, the learning con-\ntent of the activities was identical. However, the groups varied with regard to the \ndegree of bodily movement. The first 6 weeks followed the same weekly structure \ninvolving the same type of activities, and every week, four or five new letters and \nrelated sounds and two to four new words (target words) containing the letters and \nsounds were presented for the children. The last 2 weeks consisted of the repetition \nof the first 6 weeks, with a specific focus on letters with more than one pronuncia-\ntion. Thereby, the children were taught 25 letters in total and their related sounds \n(standard and conditional pronunciations) and 18 target words during the interven-\ntion period. The intervention material was developed based on the research-founded \nDanish teaching material, Fandango Mini, which is recognized and used by several \npreschool teachers in Denmark (Jacobsen & Veber Nielsen, 2011). Intervention Fandango Mini \nis based on a synthetic phonics approach and is scheduled as a 20-week systematic \ncourse covering both standard and conditional pronunciations of the letters. From \nthe very beginning, students practice reading and spelling of words composed of the \nletter-sounds trained so far (Gejl et al., 2021). Teachers and instructors were asked to keep a written log of attendance for each \nchild. Moreover, teachers and instructors were asked to note how many exercises \nwithin each session were completed and to what degree it followed the protocol. If any deviations from the protocol were observed, oral guidance was given to the \ninstructor/teacher by the research team. 1 3 Control Condition Children in the control condition (CON) performed activities similar to the two \nintervention groups with a strong focus on letter-sounds. However, the children in \nthe control condition did not perform movements beside handwriting. The activi-\nties were performed seated on a chair, individually or in random allocated pairs, \nusing pencil and paper and were administrated by their own teacher. Therefore, \nthe control condition served to follow a protocol that is typically delivered in \nschools, though closely matched to the intervention groups. The amount of time \nthe intervention group practiced phoneme movements, the intervention group \nworked on letter-sound coupling. We recognize the nature of embodied learning \ntheory and that our control group still performs embodied learning as the group \nuses handwriting and various senses (e.g., hearing) used traditionally in teach-\ning situations. From now on, this group will be described as being non-embodied \nsince our two intervention groups perform embodied learning to a larger degree \nusing whole-body and hand motor movements. Figure 1 illustrates the conditions in CON, HM, and WM groups. Intervention Conditions The two interventions groups (HM/WM) varied in regard to the motor modality \n(hand vs. whole-body movements). The participating children were taught to make \nspecific movements to letter-sounds (phoneme movements), and these movement-\nsound couplings were used throughout the intervention. The phoneme movements \nwere executed from left to right, following the reading direction, and the movements \nwere also associated with objects or living creatures (e.g., the movement coupled to \nthe sound “S” was associated with a snake). Long letter-sounds (e.g., the movement \ncoupled to the letters “O,” “A,” “S”) were performed as slow and fluent movements, \nwhile staccato letter-sounds were carried out as fast and powerful movements (e.g., \n“K,” “T,” “P”). Children in the hand movement (HM) group performed the movements only \nusing their arms and hands seated on a chair around a table with one trained instruc-\ntor. The activities were performed individually or in randomly allocated pairs. 1 3 1715 Educational Psychology Review (2022) 34:1709–1737 The participants in the whole-body movement (WM) group were standing in \na circle on the floor with one trained instructor, and they were encouraged to use \ntheir whole bodies to make the phoneme movements individually or in random \nallocated pairs. For both groups, it was important that the children performed the \nrespective phoneme movements while pronouncing the letter-sound so there was \na strong movement-sound coupling. Test Procedures Age, sex, handedness, bilingualism, height, and weight were collected prior to \nbaseline measures (T1). To evaluate the effect of the interventions, all measures \nof reading-related skills and motor skills were administrated at the schools by \ntrained instructors before (T1), after (T2) the 8-week intervention period, and \nafter a retention period of 17–22 weeks (T3) though the original protocol planned \nfor the retention test to take place after 8 weeks. This was not possible due to \nCOVID-19 (see flowchart Fig. 2.) l\nSix of the tests assessing reading-related skills and motor skills were con-\nducted individually (IT) with a trained instructor in a one-to-one session. Three \ntests were conducted in groups (GT) of 12 participants separated from one \nanother to avoid copying. The group tests were delivered by two trained instruc-\ntors. The individual tests and the group tests were performed on two separate \ndays, and the test duration for each child was approximately 60 min in total. All \ndata were two-factor registered by two instructors. Discrepancies were resolved \nby further review of the data by authors who did not register the data in the first \nplace (LD, SKJ). 1 3 Educational Psychology Review (2022) 34:1709–1737 1716 Fig. 1   Condition overview. Overview of conditions and movement/no movement in control group \n(CON), hand movement group (HM), and whole-body movement (WM) group. The HM group only per-\nformed movements using arms and hands. The WM group used their whole body to form the shapes of \nthe phonemes. Illustrated is the children performing the phoneme of the letter “Y” Fig. 1   Condition overview. Overview of conditions and movement/no movement in control group \n(CON), hand movement group (HM), and whole-body movement (WM) group. The HM group only per-\nformed movements using arms and hands. The WM group used their whole body to form the shapes of \nthe phonemes. Illustrated is the children performing the phoneme of the letter “Y” Standardized Test Two tests were performed to evaluate the children’s word reading and letter-sound \nidentification. Two tests were performed to evaluate the children’s word reading and letter-sound \nidentification. 2.\t Standardized Letter-Sound Identification Task (GT) Similar to the Word Reading Test, this test is also widely used in the Danish \nschool system. The test evaluated children’s ability to identify the first letter in a \nword read aloud. The test was administrated strictly according to the manufacturer’s \ndescription (Møller & Juul, 2013) and contained 20 items (preceded by two practice \nitems). Each item consisted of a picture followed by five letters. The words repre-\nsented by the picture were read aloud by the instructor, and the participants had to \nmark the first letter of each word. The test outcome was the total number of correct \nitems (out of 20 possible points) and used as a baseline measure of children’s letter-\nsound knowledge. 1.\t Standardized Word Reading Task (GT) The test evaluated children’s word reading accuracy and efficiency. This test is \nwidely used in the Danish school system and was administrated strictly according \nto the manufacturer’s description (Juul & Møller, 2010). The test consisted of 78 \nitems (preceded by two practice items). For each item, the children had to select \none of four pictures that corresponded to a printed word. The child should solve \nas many items at possible within a time limit of 4 min. After every minute, the \nchild was asked to change the pencil color in order to monitor their progression \nthroughout the test. The test outcomes included the number of correctly solved \nitems (efficiency) and the percentage of correctly solved items (accuracy) used \nas a measure of the transfer effect. 1 3 Educational Psychology Review (2022) 34:1709–1737 1717 Fig. 2   Flow diagram of this study. Two hundred sixteen children were invited to the project (10 classes \nfrom four different schools). Thirty-three children declined to participate. One hundred eighty-three chil-\ndren were randomly assigned to either CON (no-movement group), HM group (making hand phonemes \nusing only arms and hands), or WM (making body phonemes using their whole body). Thirty-four chil-\ndren got excluded due to diagnosis, absence during intervention, dropout, and outliers. The analysis is \nbased on 74 children from CON, 40 from HM, and 35 from WM. Due to COVID-19, one school was \nclosed which resulted in 28 children not tested at the retention test Fig. 2   Flow diagram of this study. Two hundred sixteen children were invited to the project (10 classes \nfrom four different schools). Thirty-three children declined to participate. One hundred eighty-three chil-\ndren were randomly assigned to either CON (no-movement group), HM group (making hand phonemes \nusing only arms and hands), or WM (making body phonemes using their whole body). Thirty-four chil-\ndren got excluded due to diagnosis, absence during intervention, dropout, and outliers. The analysis is \nbased on 74 children from CON, 40 from HM, and 35 from WM. Due to COVID-19, one school was \nclosed which resulted in 28 children not tested at the retention test Word Reading Two tests assessed children’s word reading. 1.\t Word Reading with Pictures (IT) 1. Word Reading with Pictures (IT)\n\t\n  To evaluate children’s ability to read the words they had been presented with \nduring the intervention (target words), we used a computer-based test made spe-\ncifically for this intervention. The test consisted of 18 representations of target 3 1718 Educational Psychology Review (2022) 34:1709–1737 Table 1   Letters, letter-sounds, and target words trained during each week of the intervention period\nEighteen Danish target words were trained in the intervention. A translation has been performed from Danish to English for further understanding for the reader of this \npaper\nWeek\n1\n2\n3\n4\n5\n6\n7 and 8\nLetters\nl\nå\ns\nm\ne\nb\ni\nu\ny\nn\nk\nf\na\næ\nh\nt\nd\ng\np\no\nj\nø\nr\nc\nv\nall\nLetter-\nsounds\n[l]\n[ɔ]\n[s]\n[m]\n[e]\n[ɛ]\n[ə]\n[b]\n[i]\n[u]\n[ɔ]\n[y]\n[n]\n[k]\n[f]\n[a]\n[ɑ]\n[ɛ]\n[h]\n[t]\n[d]\n[ð]\n[g]\n[p]\n[o]\n[ʌ]\n[j]\n[ø]\n[ʁ]\n[ɐ̯]\n[s]\n[v]\n[w]\nall\nTarget \nwords \nin \nDanish \n[pro-\nnuncia-\ntions]\nlås [ˈlɔˀs]\nbus [ˈbus]\nfly [ˈflyˀ]\ndæk [ˈdεg]\ngås [ˈgɔˀs]\nsø [ˈsøˀ]\nbåd [ˈbɔˀð]\nmel [ˈmeˀl]\nbil [ˈbiˀl]\nnul [ˈnɔl]\nhat [ˈhad]\nkop [ˈkʌb]\nrive [ˈʁiːvə]\nmur \n[ˈmuɐ̯ˀ]\nhest [ˈhεsd]\nmajs [ˈmɑjˀs]\nhav [ˈhɑw]\nkano [ˈkæːno]\nTrans-\nlated \ntarget \nwords \nto Eng-\nlish\nlock\nbus\nairplane\nrire\ngoose\nlake\nboat\nflour\ncar\nzero\nhat\ncup\nrake\nwall\nhorse\ncorn\nsea\ncanoe Table 1   Letters, letter-sounds, and target words trained during each week of the intervention period\nEighteen Danish target words were trained in the intervention. 1.\t Word Reading with Pictures (IT) The \nremaining three pictures represented words (distractors) that had either the initial \n(two pictures) or the final (one picture) sound in common with the target word. To give the correct answer, participants had to select the target word picture on \nthe touch screen. They were asked to touch the correct picture as fast as possible. The presentations of the target word and the order of the four pictures were rand-\nomized between participants and time points. The internal consistency of the test \nevaluated by the Kuder-Richardson formula 20 has previously been analyzed to \n0.872 (95% CI 0.866–0.879) (Malling et al., 2021). Word Reading with Pictures \nhas previously shown to correlate significantly with the standardized word reading \ntask accuracy (Malling et al., 2021). The outcomes from the test constituted the \nmean response time for correct answers and the number of correct answers and \nwere used as a measure of the direct training effect. 2.\t Word Reading without Pictures (IT) To test the potential transfer effects of the intervention on children’s ability to \nread short words that resembled the target words from the intervention, a computer-\nbased test made specifically for this intervention was performed. The test consisted \nof 12 untrained words (no targets words). The words were presented one at a time \nwith different letter lengths (four 2-letter words, four 3-letter words, and four 4-let-\nter words) for up to 16 s or until an answer was given. Two versions of the test were \ndelivered: one conducted at baseline (T1) and one conducted post-intervention (T2). At the retention test (T3), the test delivered at baseline was completed again. All \nversions of the test and the selection of words with the same number of letters were \npresented randomly. The child was instructed to read the word and say it aloud. The \nassessor registered the answers as correct or incorrect by pressing a green or red \nbutton on the keyboard, respectively. If no answer was given within the time limit, \na new word appeared on the screen. If incorrect or no answers were provided for all \nfour 2-letter words, the test ended. The internal consistency of the two test versions \nevaluated by the Kuder-Richardson formula 20 has previously been analyzed to \n0.896 (95% CI 0.887–0.905) and 0.891 (95% CI 0.881–0.900) (Malling et al., 2021) \nfor versions 1 and 2, respectively. Word Reading without Pictures has also shown to \ncorrelate significantly with standardized word reading task accuracy (Malling et al., \n2021). The test outcome was the number of correctly read words, and it was used as \na measure of the transfer effect. 1.\t Word Reading with Pictures (IT) A translation has been performed from Danish to English for further understanding for the reader of this \npaper\nWeek\n1\n2\n3\n4\n5\n6\n7 and 8\nLetters\nl\nå\ns\nm\ne\nb\ni\nu\ny\nn\nk\nf\na\næ\nh\nt\nd\ng\np\no\nj\nø\nr\nc\nv\nall\nLetter-\nsounds\n[l]\n[ɔ]\n[s]\n[m]\n[e]\n[ɛ]\n[ə]\n[b]\n[i]\n[u]\n[ɔ]\n[y]\n[n]\n[k]\n[f]\n[a]\n[ɑ]\n[ɛ]\n[h]\n[t]\n[d]\n[ð]\n[g]\n[p]\n[o]\n[ʌ]\n[j]\n[ø]\n[ʁ]\n[ɐ̯]\n[s]\n[v]\n[w]\nall\nTarget \nwords \nin \nDanish \n[pro-\nnuncia-\ntions]\nlås [ˈlɔˀs]\nbus [ˈbus]\nfly [ˈflyˀ]\ndæk [ˈdεg]\ngås [ˈgɔˀs]\nsø [ˈsøˀ]\nbåd [ˈbɔˀð]\nmel [ˈmeˀl]\nbil [ˈbiˀl]\nnul [ˈnɔl]\nhat [ˈhad]\nkop [ˈkʌb]\nrive [ˈʁiːvə]\nmur \n[ˈmuɐ̯ˀ]\nhest [ˈhεsd]\nmajs [ˈmɑjˀs]\nhav [ˈhɑw]\nkano [ˈkæːno]\nTrans-\nlated \ntarget \nwords \nto Eng-\nlish\nlock\nbus\nairplane\nrire\ngoose\nlake\nboat\nflour\ncar\nzero\nhat\ncup\nrake\nwall\nhorse\ncorn\nsea\ncanoe 1 Educational Psychology Review (2022) 34:1709–1737 1719 words, one word per presentation. A detailed list of target words and pronuncia-\ntions can be found in Table 1. Below the presented target word, four pictures \nwere placed where only one illustrated the target word from the intervention. The \nremaining three pictures represented words (distractors) that had either the initial \n(two pictures) or the final (one picture) sound in common with the target word. To give the correct answer, participants had to select the target word picture on \nthe touch screen. They were asked to touch the correct picture as fast as possible. The presentations of the target word and the order of the four pictures were rand-\nomized between participants and time points. The internal consistency of the test \nevaluated by the Kuder-Richardson formula 20 has previously been analyzed to \n0.872 (95% CI 0.866–0.879) (Malling et al., 2021). Word Reading with Pictures \nhas previously shown to correlate significantly with the standardized word reading \ntask accuracy (Malling et al., 2021). The outcomes from the test constituted the \nmean response time for correct answers and the number of correct answers and \nwere used as a measure of the direct training effect. words, one word per presentation. A detailed list of target words and pronuncia-\ntions can be found in Table 1. Below the presented target word, four pictures \nwere placed where only one illustrated the target word from the intervention. Letter Knowledge Three tests were performed to evaluate children’s letter knowledge. 1. Letter Naming (IT) 1. Letter Naming (IT) 1. Letter Naming (IT) 1 3 1720 Educational Psychology Review (2022) 34:1709–1737 A Danish version of the DIBELS Letter Naming Fluency test was used which \nconsisted of 12 rows of 10 letters (mixed upper and lower case) on a piece of \npaper (A4) (Good & Kaminski, 2002; Poulsen & Jensen, 2015). The child was \nasked to name as many letters as possible in 1 minute while pointing at each letter. Wrong letter-names were registered by the instructor. If the child did not name \na letter within 3 seconds, the instructor said the letter name and encouraged the \nchild to name the next letter. Prior to commencing the test, the child was provided \nwith a row of 10 letters as practice. The total number of all correctly named letters \nwas used as a baseline measure of children’s letter knowledge. 2. Naming of Letter-Sounds (Incl. the Use of Movement) (IT)\n\t\n  To assess children’s knowledge of letter-sounds, they were asked to pronounce \nthe sounds of letters “a,” “d,” “e,” “o,” “r,” “u,” and “v” which have several pos-\nsible pronunciations in Danish. In total, the test assessed the knowledge of seven \nstandard letter-sounds and eight conditional letter-sounds. The instructor read \naloud the letter-names one at a time. The child was standing up while answering \nand thereby had the opportunity to make movements to the sounds. For every \nletter-sound, the child’s answer was registered as correct/incorrect/missing, and \nit was recorded whether any movement was used. The result of the test was the \nnumber of correct letter-sounds pronounced (1) in total, (2) as standard letter-\nsounds, and (3) as conditional letter-sounds. The test was used as a measure of \nthe direct training effect. The internal consistency of the test evaluated by the \nKuder-Richardson formula 20 has previously been analyzed to 0.73 (95% CI \n0.72–0.75) (Malling et al., 2021). The number of correct letter-sounds names \nin total has shown to correlate significantly with the Standardized Letter-Sound \nIdentification Task (Malling et al., 2021). 1.\t Flamingo Balance Test (IT)l g\n\t\n  The flamingo balance test is a standardized test to assess the gross motor skill of \nbalancing on one leg (Adam, Klissouras, Ravazzolo, & Renson, 1987). Children \nwere asked to stand for 1 min with one leg on the floor and the other leg bent \nbackwards. The hand on the same side as the bent leg grasped the food. To get \nfamiliar with the test, children had one trial before the actual test. The number of \nattempts needed to stand on one leg for 1 minute was recorded for each leg. Chil-\ndren who needed more than 15 attempts within the first 30 seconds were excluded \nfrom this test. The test was only performed at T3. The test outcome was the sum \nof attempts with both legs where lower scores indicate better performance. The \ntest was used to compute a total motor skill score together with the outcomes of \nthe 9-Hole Pegboard Test described below. 2.\t 9-Hole Pegboard Test (IT) The 9-hole pegboard is a standardized test that has previously been used to evalu-\nate children’s fine motor skills (Longcamp et al., 2005; Smith et al., 2000). The test \nconsisted of a board with nine 1.3 cm (0.5 in) deep holes that were spaced 3.32 cm \n(1.25 in) apart. Sitting on a chair with the board placed in front of them, children \nwere instructed to pick up the pegs one at a time and to put them into the holes in \nany order until all of the holes were filled. Then, they were asked to remove all of \nthe pegs in any order, one at a time. There was one untimed practice trial followed \nby the test, which was timed with a stopwatch starting when the child touched the \nfirst peg until the last peg was removed. The test was conducted twice, once with the \ndominant hand and once with the opposite hand. The test outcomes included domi-\nnant and opposite hand completion times. The test was used to perform a total motor \nskill score together with the outcome of the flamingo balance test. 3.\t Letter-Sound Matching (GT) To evaluate children’s knowledge of letter-sound correspondences trained during \nthe intervention, a simple multiple-choice test was constructed on paper. The test \nconsisted of 15 trials. In each trial, a sound corresponding to a standard or a condi-\ntional pronunciation of a letter was given by the instructor. Children were instructed \nto identify the sound and match it to the correct letter given a choice of four let-\nters presented in a row on the paper (preceded by one practice trial). The internal \nconsistency of the test have been evaluated by the Kuder-Richardson formula 20 \nto 0.67 (Malling et al., 2021). Letter-Sound Matching has also shown to correlate \nsignificantly with the Standardized Letter-Sound Identification Task (Malling et al., \n2021). The 15 sounds represented both standard and conditional pronunciations of \nthe letters “a,” “e,” “o,” “r,” “u,” and “v.” The test outcomes included the number \nof correct letter-sound matches (1) in total, (2) as standard letter-sounds, and (3) \nas conditional letter-sounds. The test was used as a measure of the direct training \neffect. 1 3 Educational Psychology Review (2022) 34:1709–1737 1721 Motor Skills Two tests were performed to evaluate children’s fine and gross motor skills. Statistical Analyses Statistical analyses were performed in R studio (RStudio, 2020). Each baseline measure was compared between the intervention groups and con-\ntrol group using a one-way analysis of variance (ANOVA), and chi-square tests were \nused for the categorical measures (bilingual, dominant hand, and sex). Children with \ntest results of more than ± 2SD from the mean in two or more tests were considered \noutliers and were excluded from all analyses (n = 11). In total, data were analyzed \nbased on 74 children in CON, 40 children in HM, and 35 children in WM (149 chil-\ndren in total). Data from letter knowledge, word reading, standardized test, and motor skills \nperformance were analyzed using linear mixed models with group-time interactions 1 3 Educational Psychology Review (2022) 34:1709–1737 1722 as fixed effects, using R package lme4 (Bates, Mächler, Bolker, & Walker, 2015). The choice of using linear mixed models was especially beneficial as they allow \nto account for missing data (e.g., absent at test day). The data was analyzed using \ngroup-time interaction effect with CON, HM, and WM as groups and time as meas-\nures taken at T1, T2, and T3. “Subjects” and “school” were added to the model as \nrandom effects and “age” as fixed effect since children’s letter knowledge are age-\ndependent. Pairwise comparisons between delta values were used to characterize \ninteraction effects. To reduce the problem of multiple testing, only relevant model-\nbased specified comparisons were performed using the emmeans R package (Searle, \nSpeed, & Milliken, 2021). p value adjustment was based upon the Tukey method for \ncomparing a family of three estimates. The level of statistical significance was set to \np < 0.05.ff Cohen’s d effect sizes (Cohen, 2013) were calculated as the mean differences \nin performance divided by the pooled standard deviations. Influenced by Cohen’s \nconvention regarding magnitude of effect sizes, a Cohen’s d effect size in the range \n0.2–0.35 was considered small, in the range 0.35–0.65 moderate and > 0.65 large \n(Cohen, 2013). Correlational analysis were performed using Spearman’s rank correlation \n(Savicky, 2015). This test is nonparametric and more robust for small sample sizes. Spearman’s rank correlation was used to study the association between motor skill \nperformance and letter-sound knowledge. Table 2   Demographics of the \nthree groups (CON, HM, WM) Baseline Characteristics The chi-square tests and one-way-ANOVAs revealed no significant between-group \ndifferences for demographic data at T1 (p > 0.05) (Table 2) nor for the baseline vari-\nables on word reading and letter knowledge (p > 0.05) (Table 3). The chi-square tests and one-way-ANOVAs revealed no significant between-group \ndifferences for demographic data at T1 (p > 0.05) (Table 2) nor for the baseline vari-\nables on word reading and letter knowledge (p > 0.05) (Table 3). Table 2   Demographics of the \nthree groups (CON, HM, WM)\nData reported as mean ± SD. No significant between-group differ-\nences were observed for any of the measures. CON, control group; \nHM, hand movement group; WM, whole-body movement group\nCON\nHM\nWM\nParticipants (n)\n74\n40\n35\nAge (years)\n6.2 ± 0.4\n6.3 ± 0.4\n6.3 ± 0.3\nHeight (cm)\n122.8 ± 4.7\n122.0 ± 4.8\n122.1 ± 5.6\nWeight (kg)\n23.2 ± 3.2\n22.8 ± 3.8\n22.8 ± 3.0\nBMI (kg/m2)\n15.3 ± 1.7\n15.2 ± 1.7\n15.2 ± 1.2\nSex (% girls)\n55.41\n52.50\n40.00\nBilingualism (% bilingual)\n25.68\n25.00\n14.29\nDominant hand (% right)\n93.24\n92.50\n88.57 Data reported as mean ± SD. No significant between-group differ-\nences were observed for any of the measures. CON, control group; \nHM, hand movement group; WM, whole-body movement group\nCON\nHM\nWM\nParticipants (n)\n74\n40\n35\nAge (years)\n6.2 ± 0.4\n6.3 ± 0.4\n6.3 ± 0.3\nHeight (cm)\n122.8 ± 4.7\n122.0 ± 4.8\n122.1 ± 5.6\nWeight (kg)\n23.2 ± 3.2\n22.8 ± 3.8\n22.8 ± 3.0\nBMI (kg/m2)\n15.3 ± 1.7\n15.2 ± 1.7\n15.2 ± 1.2\nSex (% girls)\n55.41\n52.50\n40.00\nBilingualism (% bilingual)\n25.68\n25.00\n14.29\nDominant hand (% right)\n93.24\n92.50\n88.57 1 3 Educational Psychology Review (2022) 34:1709–1737 1723 Table 3   Performance at T1 (baseline) for the three intervention groups. Data reported as mean ± SD\nMeasure\nCON\nHM\nWM\nStandardized test\nStandardized letter identification task (no. of correct answers, \nmax = 20)\n8.5 ± 4.6\n9.5 ± 5.2\n8.1 ± 3.8\nStandardized word reading (no. of correct answers in 4 min)\n3.5 ± 2.4\n3.6 ± 2.7\n3.0 ± 2.0\nWord reading\nWord reading with pictures (% of correct answers)\n27.6 ± 11.5 27.0 ± 10.9 28.4 ± 13.9\nWord reading with pictures (reaction time, s)\n8.2 ± 5.5\n8.3 ± 6.0\n8.1 ± 6.5\nWord reading without pictures (no. Baseline Characteristics of correct answers, max = 12)\n0.1 ± 0.6\n0.5 ± 1.2\n0.1 ± 0.4\nLetter knowledge\nNaming of letter-sounds (no. of correct answers, max = 15)\n3.5 ± 2.3\n4.2 ± 2.5\n3.0 ± 2.5\nNaming of letter-sounds (no. of correct answers, max = 7): \nstandard\n3.3 ± 2.2\n3.9 ± 2.3\n2.9 ± 2.3\nNaming of letter-sounds (no. of correct answers, max = 8): \nconditional\n0.2 ± 0.4\n0.3 ± 0.5\n0.1 ± 0.3\nNaming of letter-sounds, movement (% of correct answers)\n8.5 ± 25.6\n5.9 ± 16.4\n3.8 ± 19.6\nNaming of letter-sounds, movement (% of correct answers): \nstandard\n8.8 ± 26.5\n6.4 ± 17.6\n3.8 ± 19.6\nNaming of letter-sounds, movement (% of correct answers): \nconditional\n9.1 ± 30.2\n0.0 ± 0.0\n0.0 ± 0.0\nLetter-sound matching (no. of correct answers, max = 15)\n6.3 ± 2.5\n6.5 ± 2.5\n6.0 ± 2.6\nLetter-sound matching (no. of correct answers, max = 7): standard\n3.9 ± 1.7\n4.1 ± 1.9\n3.8 ± 1.9\nLetter-sound matching (no. of correct answers, max = 8): condi-\ntional\n2.5 ± 1.5\n2.3 ± 1.2\n2.2 ± 1.6\nLetter naming (no. of correct answers)\n12.5 ± 10.3 14.1 ± 14.5 14.2 ± 10.0\nMotor skills\nFlamingo Balance (total touch downs left/right)\n8.0 ± 6.9\n5.2 ± 5.1\n8.4 ± 8.8\n9-Hole Pegboard (total time spent (s) dominant/nondominant)\n58.6 ± 9.4\n56.3 ± 8.6\n57.3 ± 8.1 The standardized measures suggested that the sample studied was fairly typical \nof Danish grade 0 with respect to letter-sound identification with a mean score of \n8.68, which is slightly under the published norm of 10.0 (Møller & Juul, 2013). For \nstandardized measures of word reading, the present study’s sample mean score of \n3.4 was somewhat lower than the earlier published norm from a study with children \nat the end of grade 0 (17.8) (Malling et al., 2021). The same was seen for letter nam-\ning fluency with a mean score of 13.37 compared to published norm from Malling \net al. (2021) of 38.49. The baseline characteristics for the sample studied are thereby \nexpected since the participating children started attending grade 0 only 1  month \nprior to testing. Baseline Characteristics To investigate whether the teaching condition (CON, HM, WM) had a direct \ntraining effect on children’s letter knowledge and word reading skills post-interven-\ntion and at retention (research question 1), analysis was performed on the following 1 3 1724 Educational Psychology Review (2022) 34:1709–1737 Table 4   Improvement from pre (T1) to post (T2) or retention test (T3)if\nMeasure (delta)\nT1 >  > T2\nT1 >  > T3\nCON\nHM\nWM\nCON\nHM\nWM\nStandardized test\nStandardized word reading (no. of correct answers in 4 min)\n5.3 ± 1.1\n5.6 ± 1.4\n6.7 ± 1.5\n13.1 ± 1.1\n15.1 ± 1.6\n16.8 ± 1.7\nWord reading\nWord reading test with pictures (% of correct answers)\n20.0 ± 3.2\n20.7 ± 4.2\n13.5 ± 4.5\n30.9 ± 3.3\n39.4 ± 4.7\n32.7 ± 5.0\nWord reading test with pictures (Reaction time, s)\n0.1 ± 0.8\n − 0.1 ± 1.1\n0.5 ± 1.2\n − 0.3 ± 0.8\n − 0.7 ± 1.2\n − 0.3 ± 1.3\nWord reading test without pictures (no. of correct answers, max = 12)\n1.9 ± 0.4\n2.0 ± 0.6\n2.1 ± 0.6\n4.8 ± 0.5\n5.3 ± 0.7\n4.7 ± 0.7\nLetter knowledge\nNaming of letter-sounds (no. of correct answers, max = 15)\n2.9 ± 0.3\n3.9 ± 0.4\n5.0 ± 0.4a\n4.2 ± 0.3\n4.8 ± 0.4\n5.5 ± 0.5a\nNaming of letter-sounds (no. of correct answers, max = 7): standard\n1.9 ± 0.2\n1.8 ± 0.3\n2.7 ± 0.3\n3.0 ± 0.2\n2.5 ± 0.4\n3.4 ± 0.4\nNaming of letter-sounds (no. of correct answers, max = 8): conditional\n1.0 ± 0.2\n2.1 ± 0.3a\n2.2 ± 0.3a\n1.3 ± 0.2\n2.2 ± 0.3a\n2.1 ± 0.3\nNaming of letter-sounds, movement (% of correct answers)\n0.1 ± 4.5\n64.8 ± 5.9a\n66.5 ± 6.6a\n − 2.8 ± 4.6\n15.8 ± 6.5\n30.3 ± 7.2a\nNaming of letter-sounds, movement (% of correct answers): standard\n − 0.5 ± 4.6\n62.9 ± 6.0a\n63.8 ± 6.6a\n − 4.4 ± 4.7\n14.4 ± 6.7\n28.5 ± 7.2a\nNaming of letter-sounds, movement (% of correct answers): conditional\n7.2 ± 10.9\n91.9 ± 10.8a\n73.0 ± 16.2a\n5.3 ± 10.7\n27.5 ± 11.6\n37.6 ± 16.3\nLetter-sound matching (no. of correct answers, max = 15)\n3.1 ± 0.3\n4.3 ± 0.4\n3.7 ± 0.5\n4.2 ± 0.3\n4.9 ± 0.5\n5.2 ± 0.5\nLetter-sound matching (no. Baseline Characteristics of correct answers, max = 7): standard\n1.8 ± 0.2\n2.1 ± 0.3\n2.0 ± 0.3\n2.4 ± 0.2\n2.2 ± 0.3\n2.3 ± 0.4\nLetter-sound matching (no. of correct answers, max = 8): conditional\n1.2 ± 0.3\n2.1 ± 0.3\n1.7 ± 0.4\n1.7 ± 0.3\n2.6 ± 0.4\n2.9 ± 0.4a 1 3 Educational Psychology Review (2022) 34:1709–1737 1725 Fig. 3   Results of children’s \nability to name letter-sounds for \na given letter. A The mean delta \nscore of % max score (y-axis) \nof naming letter-sounds (both \nstandard and conditional pro-\nnunciations) within the groups \nCON, HM, and WM. A signifi-\ncant difference between WM \nand CON was seen from T1 to \nT2 (***) and T1 to T3 (*). B \nThe mean delta score of % max \nscore (y-axis) of naming stand-\nard letter-sounds within the \ngroups CON, HM, and WM. No \nsignificant differences between \nthe groups were seen. C The \nmean delta score of % max score \n(y-axis) of naming conditional \nletter-sounds within the groups \nCON, HM, and WM. A signifi-\ncant difference was seen from \nT1 to T2 (**) for both WM and \nHM compared to CON. From \nT1 to T3, a significant difference \n(*) was seen between HM and \nCON. *, p < 0.05; **, p < 0.01; \n***, p < 0.001 Fig. 3   Results of children’s \nability to name letter-sounds for \na given letter. A The mean delta \nscore of % max score (y-axis) \nof naming letter-sounds (both \nstandard and conditional pro-\nnunciations) within the groups \nCON, HM, and WM. A signifi-\ncant difference between WM \nand CON was seen from T1 to \nT2 (***) and T1 to T3 (*). B \nThe mean delta score of % max \nscore (y-axis) of naming stand-\nard letter-sounds within the \ngroups CON, HM, and WM. No \nsignificant differences between \nthe groups were seen. C The \nmean delta score of % max score \n(y-axis) of naming conditional \nletter-sounds within the groups \nCON, HM, and WM. A signifi-\ncant difference was seen from \nT1 to T2 (**) for both WM and \nHM compared to CON. From \nT1 to T3, a significant difference \n(*) was seen between HM and \nCON. *, p < 0.05; **, p < 0.01; \n***, p < 0.001 1 3\t\ne mean delta \nre (y-axis) \nunds (both \ntional pro-\nthe groups \nM. A signifi-\nween WM \nfrom T1 to \nT3 (*). Baseline Characteristics B \nre of % max \nming stand-\nithin the \nand WM. No \nces between \nen. C The \n % max score \nconditional \nn the groups \nM. A signifi-\nseen from \noth WM and \nON. From i\nant difference \nen HM and \n*, p < 0.01; 1 3 3 3 Educational Psychology Review (2022) 34:1709–1737 1726 three measures: Naming of Letter-Sounds, Letter-Sound Matching, and Reading \nTest with Pictures. Naming of Letter-Sounds: A between-group analysis showed that WM improved \ntheir ability to name letter-sounds correctly significantly more than CON both from \nT1 to T2 ­(CONT1–T2 = 82% versus WM T1–T2 = 167%, p < 0.001, d = 2.8) and from \nT1 to T3 ­(CONT1–T3 = 120% versus WM T1–T3 = 183% p < 0.05, d = 0.7) (see Table 4 \nfor absolute values and Fig. 3 for percentages). Further, it was found that both the \nhand motor movement group (HM) and the whole-body movement group (WM) \nimproved significantly better at naming conditional letter-sounds compared to the \ncontrol group (CON) from T1 to T2 ­(WMT1–T2 = 1050% and ­HMT1–T2 = 700% versus \n­CONT1–T2 = 500%, p < 0.01, d = 0.6, p < 0.01, d = 0.5) and also from T1 to T3 for the \nHM group compared to CON ­(CONT1–T3 = 650% versus HM T1–T3 = 733% (p < 0.05, \nd = 0.5). f Letter-Sound Matching: There were no between-group differences on the total \nscore or standard letter-sounds, but for the conditional letter-sounds, there was a sig-\nnificant difference between WM and CON from T1 to T3 ­(CONT1–T3 = 68% versus \nWM T1–T3 = 132%, p < 0.05, d = 3.0; see Table 4 for absolute values and Fig. 4 for \npercentages).if No significant differences were seen in Reading Test with Pictures. gif\ng\nFollowing both WM and HM interventions, it was evident that movements \nbecame an important part of children’s processing of letter-sounds. During the let-\nter-sound test, none of the children in the CON group supported their answers with \nmovements. In contrast, pooled data from WM and HM groups showed that 53% \nof children supported their answers with movements. Due to the significant differ-\nence between the groups in the naming of letter-sounds, we wanted to investigate \nif children’s motor skill performance would be associated with their choice to use \nmovement while pronouncing the letter-sound (research question 3). Baseline Characteristics An exploratory \nSpearman correlation showed no significant correlation (p > 0.05) between the chil-\ndren’s motor skills performance score and the prevalence of using movement while \nnaming letter-sounds. This might indicate that there is no relationship between chil-\ndren’s degree of motor skill performance score and their ability to learn letter-sound \ncorrespondences by embodied learning. Embodied Learning Effect on Children’s Pre‑Reading Skills The present study provides supportive evidence to our hypothesis that embod-\nied learning activities have an effect on children’s letter-sound knowledge \nlearning. We found that using whole-body movements and hand motor move-\nments while learning letter-sound correspondences was associated with better \nlearning outcomes compared with non-embodied training post-intervention. When looking more deeply into the types of letter-sounds, it was found that \nchildren from both intervention groups (whole-body and hand motor) improved \nin their ability to recall conditional letter-sounds post-intervention. The fact Educational Psychology Review (2022) 34:1709–1737 1727 Fig. 4   Results of children’s \nability to match letters with \nletter-sounds. A The mean delta \nscore of % max score (y-axis) of \nmatching sounds to a letter (both \nstandard and conditional letter-\nsounds) within the groups CON, \nHM, and WM. No significant \ndifferences between groups were \nseen from T1 to T2 and T1 to \nT3. B The mean delta score of \n% max score (y-axis) of match-\ning standard letter-sounds to a \nletter within the groups CON, \nHM, and WM. No significant \ndifference between groups was \nseen from T1 to T2 and T1 to \nT3. C The mean delta score of \n% max score (y-axis) of match-\ning conditional letter-sounds to \na letter within the groups CON, \nHM, and WM. A significant \ndifference (*) was seen from T1 \nto T3 between WM and CON. *, p < 0.05; **, p < 0.01; ***, \np < 0.001 1 3 3 3 Educational Psychology Review (2022) 34:1709–1737 1728 that the intervention effect was mainly seen on the conditional letter-sounds \nshould probably be explained by the order in which children usually acquire \nthe sounds of letters. Initially, children acquire the standard sounds of the let-\nters, which to a large extent correspond to the names of the letters (Treiman \net al., 1998). At the beginning of grade 0, students already know at least half of \nthe letters of the alphabet (Juul, 2008b), and when children know the names of \nthe letters, they are not far from knowing their standard sounds as well. Typi-\ncally, children need to master the standard sounds of the letters before acquir-\ning their conditional sounds (Elbro, 2013). Children can either learn the con-\nditional sounds directly through teaching or indirectly by mapping the spelling \nof words with their pronunciation while decoding them. Transfer Effects to Word Reading Skills Considering the significant improvement in letter-sound knowledge in both move-\nment groups, we expected that the interventions would also facilitate the trans-\nferability of the learnt skills. However, no transfer effects were observed, and our \nhypothesis was not supported. Several reasons might explain this finding. i\nBefore children can understand the alphabetic code, that sounds and letters can \ncombine, which, in turn, will allow for the development of basic word reading skills, \nthey need both phoneme awareness and letter knowledge (e.g., Bowey, 2005). So, to \nobserve a transfer effect from T1 to T2 on word reading, the children participating \nin the 8-week intervention would have had to acquire letter-sound knowledge profi-\nciency and translate their newly gained knowledge into a basic word reading strat-\negy. Our data show that this was not obtained. If we use an accuracy level of 70% \ncorrect for reading short regular words (based on word reading without pictures) \nas a criterion for the achievement of basic word reading skills as suggested by Juul \net al. (2014), we find that only 4% of all children acquired basic word reading skill \nduring the intervention period. Further, at T3, 7–8 months after school starts, the \nproportion of children that had acquired basic word reading skills had risen to 29%. This corresponds to the proportion found in a study by Malling et al. (2021) after \n7 months of semiformal literacy instruction common of Danish schools (Malling \net al., 2021). Hence, regardless of teaching condition, the intervention did not boost \nchildren’s development of basic word reading skills.i We have no specification of the literacy instruction the children took part in dur-\ning the retention period, but it might be the case that the children did not have had \nsufficiently word reading practice neither during the intervention period nor during \nthe retention period to profit from their enhanced letter-sound knowledge. While \nsome intervention activities involved the combination of spelling and reading to \nsome extent, perhaps further practice and more focus on word spelling and word \nreading would be required to allow for the development of basic word reading skills, \nand so, transfer effects could potentially be found later in the school year. Mavilidi \nand colleagues (2018) demonstrated that spelling improved following 4 weeks of \n120-min intervention per week (Mavilidi et al., 2018). Therefore, one speculation \nof the present study is that spelling measures could potentially demonstrate inter-\nvention transfer effects. Embodied Learning Effect on Children’s Pre‑Reading Skills Since the intervention \ntook place at the beginning of grade 0, most children had no prior knowledge \nof conditional letter-sounds, and so, they needed to learn and recognize these \nsounds as alternative pronunciations of the letters alongside their names and \nstandard pronunciations. Altogether, these results suggest that learning of let-\nter-sound correspondences with the integration of congruent bodily movements \nmay have an advantage over conventional methods. When comparing present results with children who attended school for 4 \nmore months following standard curriculum for grade 0 (Malling et al., 2021), \nwe see that the hand motor movement group and whole-body movement group \nperform significantly better when recalling conditional letter-sounds (~ 15% vs \n7% correct answers) at T2 (data not shown). We found no evidence to suggest \nthat letter-sound knowledge differed in the WM group when tested immediately \nafter the intervention and following the retention period. This indicates a high \nlikelihood of maintaining the acquired knowledge. Engelkamp and Zimmer \n(1989) argued that information is memorized better if the learner performs the \ndescribed action during learning compared to just getting verbal information, \nalso known as the enactment effect. According to this theory, the embodied \nlearning groups should memorize the letter-sounds and letter-sound movements \nbetter compared to the children who participated in conventional verbal learn-\ning. This emphasizes the powerful effect of embodied learning on children’s \npre-reading skills. These findings are in accordance with previous studies that have shown \nthe association between the integration of bodily movements during academic \nlearning (e.g., new foreign words) and higher learning outcomes (Mavilidi \net al., 2015). The interventions delivered in the current study had the unique \nmerit of integrating meaningful movements that were closely associated with \nthe corresponding letter-sounds, and it suggests that the delivered exercises had \na sufficient cognitive load level without risk of cognitive overload (Sweller, \n2011). As seen in previous research on enactment and gesturing, learning \ninvolving meaningful bodily movements enhances memory for specific infor-\nmation (e.g., letter-names and letter-sounds) caused by more elaborate repre-\nsentations following motor engagement (action-event memory formation), \nwhich may explain the present study results (Engelkamp & Zimmer, 1989; \nMadan & Singhal, 2012). 1 3 Educational Psychology Review (2022) 34:1709–1737 1729 The Relationship between Motor Skills and Letter‑Sound Knowledge In addition, we wanted to investigate the association between children’s motor skills \nand their pre-reading and word reading skills. We expected a significant relation-\nship based on other studies that reported significant correlations between children’s \nmotor skills and academic performance (Cameron et al., 2016; Geertsen et al., 2016; \nMurrah, 2010). The present study did not find any evidence to support this claim \nsince no correlations were found between balance and dexterity measures and aca-\ndemic outcomes. Further correlational analyses were performed to see if children’s \nmotor skills were associated with the prevalence of using movements while nam-\ning letter-sounds, but no evidence for such association was found. We did not find \nany evidence to suggest that children could be limited in their ability to participate \nin movement-based learning and thereby not benefit from the facilitative effects \nof this learning strategy. However, this contrasts with other findings. For instance, \nBotha and Africa (2020) found a significant correlation between reading skills and \nmotor skills in a study with 6–7-year-old children. They used the short form of the \nBruininks-Oseretsky Test of Motor Proficiency second edition (BOT-2) (Bruininks \n& Bruininks, 2005) which includes 14 items within five different movement areas \n(Botha & Africa, 2020), therefore providing a comprehensive assessment of individ-\nual motor proficiency. It has been suggested that different types of motor skills are \nassociated with specific cognitive processes throughout development (Ludyga et al., \n2019; Piek et al., 2008), so this motor and reading skills relationship was more likely \nto be detected with a more comprehensive battery of motor skill assessments. The \npresent study only evaluated participating children’s superficial motor functioning \nusing one gross motor skill test (flamingo balance test) and one fine motor move-\nment test (pegboard). This was sufficient for the aims of the current study as both \ntests are sensitive enough to indicate significant motor difficulties. However, future \nresearch looking at the relationship between motor and reading skills should con-\nsider using more comprehensive motor skills assessments such as BOT-2 (Bruininks \n& Bruininks, 2005). Transfer Effects to Word Reading Skills However, this type of testing was not performed and there-\nfore remains a potential focus for future research. Intervention duration and intensity \ncould also explain the absence of transfer effects on reading skills in the present \nstudy. Botha and colleagues (2020) demonstrated a significant effect of a visuomo-\ntor intervention on reading skills using a standardized reading test, which is similar \nto the reading test used in the present study (Botha & Africa, 2020). However, they \nused an intervention of 12 weeks with 120 min a week (in total 1440 min), which is \ntwice the exposure time compared to the present study (8 weeks of 90 min = 720 min \nin total). Therefore, it could be assumed that the manifestation of transfer effects \nmay be dependent on the dose of reading activities. 1 3 Educational Psychology Review (2022) 34:1709–1737 1730 Whole‑Body vs Hand Movements Based on our results, there is no evidence to indicate that the amount of bodily \nengagement (using arms vs using the whole body) affected the consolidation of the \nletter-sound knowledge immediately after the intervention. However, the amount of \nbodily engagement was observed to have a long-term effect with significant differ-\nences observed following the retention period. This indicates that it is important to \nhave high bodily engagement and task integration to improve learning efficiency for \nlong-lasting gains in the context of letter-sound knowledge. This is in line with Skul-\nmowski’s conclusion; studies with low bodily engagement or only incidental embod-\niment manipulations result in weak effects on some performances, and increasing \nthe degree of bodily engagement and integration may in some cases lead to higher \nlearning outcomes (Skulmowski & Rey, 2018). In connection, Craik and Lochart’s \n(1972) processing framework suggested that information processed deeply is easier \nto remember. This may be an explanation for the long-lasting effect for our whole-\nbody movement group, where the higher level of bodily engagement may induce \ndeeper processing benefitting memory encoding and retrieval (Madan & Singhal, \n2012). However, further studies are needed to find the underlying mechanism behind \nthis finding. i\nWe recommend that teachers should incorporate movement-based teaching in \ntheir standard teaching curricula with specific consideration for whole-body move-\nments. Some studies report a risk of cognitive overload with high bodily engage-\nment, and in the end, some researchers have defined a medium degree of interactiv-\nity to be best suited for increasing learning performance. Our findings may thereby \nbe found in both the degree of embodiment and the high task integration, without \ncausing a cognitive overload for the children. For interest, every activity used in the intervention can be found in our protocol \narticle from 2021 (Gejl et al., 2021). Movements vs Handwriting In this study, movement and learning content in the two intervention groups had \na close connection. Based on Skulmowski taxonomy, our whole-body movement \ngroup had a high bodily engagement and high task integration, whereas the hand \nmovement group had a low bodily engagement and high task integration (Skulmo-\nwski & Rey, 2018). This was in contrast to our control group which did not have a \nhigh bodily engagement, and the task integration was more incidental. The control \ngroup did not combine handwriting with letter-sounds, and thereby, the integration \nwas more incidental. Previous research has suggested that handwriting constitutes a \nmotor-embodied learning task that is beneficial for, e.g., recognizing letters at start of \nliteracy (James, 2017; Longcamp et al., 2005). However, our results indicate that high 1 3 Educational Psychology Review (2022) 34:1709–1737 1731 bodily engagement and high task integration are superior since intervention groups \nperformed significantly better in letter-sound knowledge compared to control situa-\ntion, who only performed handwriting. Thereby, we recommend that activities with a \nhigh bodily engagement and task integration are used as a supplement to handwriting \nwhen learning children’s letter-sound associations. Acknowledgements  We would like to thank all the included schools, teachers, and most importantly \nthe children for participating in the study. The authors are thankful for all participating instructors who \ncontributed the intervention: Søren Kildahl, Johannes Nyled Madsen, Hjalte Riis, Mette Finne, Magnus \nBroløs, Cecilie Holland Frimann, Thea Zeuthen Madsen, Rasmus Ahmt, Magnus Ask Røgilds, Anne \nHusted Henriksen, Rebekka Læssøe Markers, Anton Vergod Knudsen, Søren Ydemark, and Lin Tinan-\ngon. We also thank Postdoc Martha Topor for proofreading and statistician Associate Professor Christian \nRitz for support and assistance on the statistics. Finally, we thank the Independent Research Fund Den-\nmark for funding the research project. Strengths and Limitations One important strength of the study was the high level of control and randomization. Having developed teaching material based on the research-founded Danish teaching \nmaterial, Fandango Mini, which is recognized and used by several preschool teach-\ners in Denmark (Jacobsen & Veber Nielsen, 2011), we ensured that all participants \nwere taught exactly the same content. The difference between the three groups was \nthe degree of movement ranging from incidental handwriting to whole-body move-\nments. The two movement groups were extremely similar and were very much alike. 1 3 1732 Educational Psychology Review (2022) 34:1709–1737 The difference in the delivered intervention was conceptualized by the degree of \nbody engagement as either the hand movements (i.e., low movement range primarily \nusing small muscles) or the whole-body movement (i.e., high movement range using \nsmall and large muscles). This presents a unique contribution of the current study to \nthe field of embodied learning as it addresses the important distinction between the \ntypes of movements that can be applied in educational interventions, which is not \ncommonly observed in the literature. The activities in the two intervention (WM/HM) groups were performed by \ntrained external instructors and by the class’ own teacher in CON. This difference \ncould have an impact on the outcome of the study. Children in CON could have \nan advantage over the movement groups because they had their own teacher with \nwhom they were more familiar. This could present a greater opportunity to achieve \nbetter outcomes following the intervention period. It was observed that some teach-\ners in the control condition used movement themselves when teaching letter-sound \ncorrespondences. However, we did not find any effects in the knowledge of letter-\nsound correspondences for CON compared to the other groups which indicate the \nimportance of children performing movement themselves instead of watching teach-\ners performing movements.i The fidelity was evaluated by register the amount of performed exercises and \ncompliance to the protocol was registered to ensure the quality of the intervention. Motivation was measured during the intervention with a developed question-\nnaire (Gejl et al., 2021). However, the children were not able to perform it correctly, \nwhich is why data is not analyzed because of mistrust of data. Conflict of Interest  The authors declare no competing interest. Open Access  This article is licensed under a Creative Commons Attribution 4.0 International License, \nwhich permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as \nyou give appropriate credit to the original author(s) and the source, provide a link to the Creative Com-\nmons licence, and indicate if changes were made. The images or other third party material in this article \nare included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the \nmaterial. If material is not included in the article’s Creative Commons licence and your intended use is \nnot permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission \ndirectly from the copyright holder. To view a copy of this licence, visit http://​creat​iveco​mmons.​org/​licen​\nses/​by/4.​0/. Conclusion The present intervention study contributes to the understanding of embodied learn-\ning and its use to improve children’s letter-sound knowledge. We conclude that there \nare beneficial effects of using whole-body movements for children when learning \nletter-sounds. In addition, hand motor movements also had an effect on letter-sound \nknowledge; however, the whole-body movements had longer-lasting effects. Further intervention studies focusing on the underlying mechanisms of embod-\nied learning effects should be investigated, and more intervention studies focusing \non the degree of embodiment should be performed. From a practical perspective, \nteachers should consider integrating a higher degree of embodied learning activi-\nties when teaching letter-sound correspondences in early literacy instruction. Acknowledgements  We would like to thank all the included schools, teachers, and most importantly \nthe children for participating in the study. The authors are thankful for all participating instructors who \ncontributed the intervention: Søren Kildahl, Johannes Nyled Madsen, Hjalte Riis, Mette Finne, Magnus \nBroløs, Cecilie Holland Frimann, Thea Zeuthen Madsen, Rasmus Ahmt, Magnus Ask Røgilds, Anne \nHusted Henriksen, Rebekka Læssøe Markers, Anton Vergod Knudsen, Søren Ydemark, and Lin Tinan-\ngon. We also thank Postdoc Martha Topor for proofreading and statistician Associate Professor Christian \nRitz for support and assistance on the statistics. Finally, we thank the Independent Research Fund Den-\nmark for funding the research project. 1 3 1733 Educational Psychology Review (2022) 34:1709–1737 Author Contribution  LD, JW, AKG, AMVN, and ASBM designed the experiment. LD collected the data. LD and SKJ conducted the required data analysis, and LD drafted the first version of the manuscript. All \nauthors contributed to drafting the manuscript and approved the final version of the manuscript. 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