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RAP On Reading Comprehension Plan

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The article discusses using the self-regulated strategy development (SRSD) model to teach students the Read-Ask-Paraphrase (RAP) reading comprehension strategy.

Mrs. Brown suggested teaching students the Read-Ask-Paraphrase (RAP) reading comprehension strategy.

The team noticed that some students were fluent readers but struggled with comprehension, which surprised them since they had assumed comprehension followed fluent reading.

The"RAP" on Reading Comprehension

Teaching Exceptional Children, Sep/Oct 2010 by


Hagaman, Jessica L, Luschen, Kati, Reid, Robert
Mrs. Brown is the special education teacher for the third-grade team at Casey Elementary
School. Recently, the team realized that some of their students had problems with reading
comprehension. As a part of their response to intervention (RTI) program, the team
assesses students' reading fluency every 2 months using Dynamic Indicators of Basic
Early Literacy Skills (DIBELS; Good & Kaminski, 2002) to ensure students are
improving and meeting district benchmarks. The team noticed that the majority of the
third graders were meeting their fluency benchmarks and could decode at grade level,
thus meeting their instructional goals. However, they also noticed that a few students
were well behind their peers in reading comprehension skills despite the fact that their
fluency was at or above district benchmarks. This came as a surprise to the team because
they had always thought comprehension of text automatically followed fluent reading.
They knew they had to address this issue immediately so these students wouldn't fall
behind their peers; however, they weren't sure how to improve the comprehension skills
of these students. Mrs. Brown suggested teaching the students a reading comprehension
strategy. She suggested that they look for a simple and flexible comprehension strategy.
They needed a strategy that could be taught individually or in small groups in the general
education classroom or resource room. The strategy should also be one that students can
master quickly. In addition, Mrs. Brown suggested teaching the strategy using the self-
regulated strategy development (SRSD; Harris & Graham, 1996) model because she
knew that how a strategy is taught is a critical factor in its success or failure (Reid &
Lienemann, 2006).

Many teachers have encountered similar issues with reading comprehension in their
classrooms. In fact, reading problems aie one of the most frequent reasons students are
referred for special education services (Miller, 1993) and the disparity between students
with reading difficulties and those who read successfully appears to be increasing (U.S.
Department of Education, 2003). As a result, there is now an emphasis on early
intervention programs such as RTl. In many cases, early intervention in reading
instruction focuses primarily on foundational reading skills, such as decoding. These
foundational skills allow the reader to read fluently (i.e., with speed and accuracy;
National Reading Panel, 2000). However, with much of the focus on fluency, reading
comprehension may be overlooked. It's true that reading fluency is necessary for
comprehension. Students who are able to decode and recognize words effortlessly are
able to devote more of their cognitive resources to reading comprehension. As a result,
readers who are fluent are more likely to have better comprehension skills (Fuchs, Fuchs,
Hosp, & Jenkins, 2001). This link between fluency and comprehension can lead teachers
to assume that if students can read fluently they should also be able to comprehend what
they read.
For many students, this assumption is correct; however, there are students who are fluent
readers who experience difficulties with reading comprehension. Up to 10% of students
are fluent readers who struggle to understand what they read (Meisinger, Bradley,
Schwanenflugel, Kuhn, & Morris, 2009; Shankweiler, Lundquist, Dreyer, & Dickinson,
1996). These students are able to successfully decode text in specific content areas, such
as sciences and social studies, but are unable to process and comprehend what they read
(Caccamise & Snyder, 2005). One way to improve these students' comprehension skills is
by teaching them effective comprehension strategies. Research shows that explicit
instruction of reading comprehension strategies can significantly improve students'
comprehension skills (Gajria, Jitendra, Sood, & Sacks. 2007; Pressley, Brown, El-Dinary,
& Allferbach, 1995). Unfortunately, research also shows that comprehension instruction
is often rudimentary and instruction in actual comprehension strategies (i.e., specific
procedures students can use to increase their comprehension) is rare (Vaughn, Levy,
Coleman, & Bos, 2002). As a result many students do not improve their ability to
comprehend text. In addition, few teachers are knowledgeable about how to effectively
teach a strategy (Reid & Lienemann, 2006) - and unless all the critical instructional
elements are included, students are unlikely to benefit from a strategy.

How can special educators implement an effective reading comprehension strategy with
young students who exhibit reading comprehension problems? We taught the RAP
strategy (Read-Ask-Paraphrase; Schumaker, Denton, & Deshler, 1984) to Gary, Betty,
and Jean, third-graders with reading comprehension problems. The results of our Tier II
intervention (Hagaman, Casey, & Reid, in press) demonstrate that teaching young
students such a strategy can markedly improve their reading comprehension.

The RAP Strategy

RAP (Schumaker et ah, 1984) is a simple strategy that is easily incorporated into existing
curriculum without taking time away from critical content instruction. This three-step
strategy (see Figure 1) can improve the reading comprehension of students with and
without disabilities and is extremely flexible. It can be used for elementary, middle, and
high school students across many different content areas (Hagaman & Reid, 2008).

The strategy requires students to engage in reading materials through questioning and
paraphrasing to increase their comprehension of the material. From the questioning and
paraphrasing, students process information for better understanding of what they read.
Studies using the RAP strategy (Schumaker et al., 1984) have shown it to be effective
(e.g., Hagaman, Casey, & Reid, in press; Hagaman. & Reid, 2008; Katims & Harris,
1997). Results from these studies showed marked improvement in reading
comprehension across multiple age groups (e.g., elementary through high school), and for
students with and without disabilities (e.g., learning disabilities). In short, the RAP
strategy can easily be incorporated into existing curriculum as a support for a variety of
readers who struggle with comprehension.

The Self-Regulated Strategy Development Model


Effective strategy instruction requires teachers to explicitly teach students the use of the
strategy, model die strategy, cue students to use the strategy, and scaffold instruction to
gradually allow the student to become an independent strategy user (Reid & Lienemann,
2006). We used the SRSD model to teach the RAP strategy (Schumaker et al., 1984)
because SRSD is a well- validated model with over 20 years of research support that
incorporates all the vital components of strategy instruction in me reading process (Harris
& Graham, 1996). The SRSD model uses six stages for teaching strategies to ensure
student mastery and generalization:

1 . Development of background knowledge.

2. Discussion of the strategy steps.

3. Strategy modeling.

4. Memorization.

5. Support of the strategy.

6. Independent performance.

The stages are flexible and may be combined or reordered. Lessons typically involve
activities from multiple stages; for example, memorizing a strategy is incorporated into
all the lessons. Table 1 lists RAP strategy activities for each stage of the SRSD model.

Each of these stages contributes to students' eventual mastery of the strategy. Note that
instruction is mastery based: Students do not move to the final stage until they can use the
strategy fluently and without teacher assistance. Fluent use of a strategy is critical
because it allows students to use die strategy without taxing their working memory.
Struggling students often have difficulty because their working memory is overloaded
and information is not processed properly (e.g., Gathercole, Alloway, Willis, & Adams,
2006; Swanson, Howard, & Saez, 2007). This in turn can translate into problems such as
difficulty storing and retrieving information. Strategy instruction teaches students how to
do each step of the strategy and why each of those steps are important to accomplish their
task (e.g., remembering what you read). Strategy instruction also entails teaching students
metacognitive information about the strategy (e.g., the "hows" and "whys" of a strategy),
because use of a strategy requires much more than rote knowledge of steps. Instruction is
scaffolded (i.e., responsibility for strategy use is gradually shifted from the teacher to the
student) to allow students to become independent strategy users.

Teaching the RAP Strategy

Develop and Activate Background Knowledge

In this stage, die instructor identifies if the student has the necessary skills to perform the
chosen strategy. In most cases, the instructor will already know this information from
working with the student on a regular basis; otherwise a task analysis can be performed.
This analysis identifies and defines the skills necessary to use the strategy and then
determines whether the student has the necessary skills. Direct observation of the student
or curriculum-based measures can work well for this analysis. For the RAP strategy
(Schumaker et al., 1984), the instructor might assess whether the student is a fluent
reader, as proficient fluency can influence whether students understand what they read
(National Reading Panel, 2000). In addition, the instructor will want to ensure that
students understand what a paragraph is and what main ideas and details are in a
paragraph. After the instructor has determined that students have the necessary
prerequisite skills and background knowledge to use the strategy, the students can learn
the specific steps of the strategy.

When we taught the RAP strategy (Schumaker et al., 1984) to three thirdgraders, Gary,
Betty, and Jean, we first determined whether the students were able to read fluently at
grade level using DIBELS middle-of-the-year benchmark probes (Good & Kaminski,
2002). We then asked the students to read a short paragraph aloud and identify the main
idea and two details. As the students identified each element, we wrote down their
responses. This assessment helped us determine whether die students understood the
components of a paragraph (i.e., the main idea and details).

Discuss the Strategy

In the second stage of the SRSD model (Harris & Graham, 1996), the instructor should
help the student continue to understand the uses for the strategy. The instructor should
introduce the strategy to the student and activate his/her background knowledge on the
topic. For example, the instructor may ask the student to brainstorm what makes a good
reader or why reading is important (e.g., good readers understand what they read, enjoy
reading). At this time, the mnemonic device "RAP" should be presented to the student
and discussed. The instructor should explain each step of the strategy in the reading
process (see Figure 1); the use of a cue card or graphic organizer can help students
remember the steps of the strategy. The instructor should present the strategy as a "trick"
to help students remember what they read.

An important component of this stage is obtaining student "buy>in." Getting a student to


buy in to using die strategy is extremely important. If students are not committed to
learning and using a strategy, it is unlikely that they will use the strategy independently,
which is one of the goals of SRSD (Harris & Graham, 1996) instruction. For the RAP
strategy (Schumaker et al., 1984), student buy-in can be accomplished by reviewing
previous measures of reading comprehension (e.g., curriculum-based measures, unit
tests). This information should be graphed so students can clearly see a need to improve
their reading comprehension (see Figure 2).

After discussing with the student how using the RAP strategy (Schumaker et al., 1984)
can improve reading comprehension, the instructor should work with the student to set a
performance goal (see Table 2). Graphs are often an effective way to illustrate student
progress towards their self determined goals. For example, die instructor may ask the
student to graph current reading performance (e.g., percentage or number correct on a
curriculum-based measure) over time to show improvement. Students can compare the
current graph with their previous baseline performance. Graphing and goal setting also
serve as self-regulation strategies, and feedback serves to reinforce performance. Note
that goal setting and graphing also can be highly motivating to students.

For goal setting, we showed Gary, Betty, and Jean a graph of their previous performance
gathered during baseline, and discussed how they each might improve their performance
by using the RAP strategy (Schumaker et al., 1984). The students then set individual
goals related to how much information they could recall from given text. We worked with
the students to ensure they set realistic goals directly related to their current performance
(e.g., if a student recalled 17% of text in baseline, an appropriate goal might be 40%).
The students would record their future scores on a graph to self-monitor progress toward
their self-determined goal. Initial goals for Gary, Betty, and Jean were 35%, 40%, and
50% respectively. When students met a self-determined goal, we worked with them to set
a new goal.

We also encouraged the students to self-monitor their use of the strategy. We taught them
to develop a plan to make sure they were following each step of the strategy as Lhey read
a passage. Most students monitored their use of the strategy by taking notes or making
tally marks while they read a passage to indicate they had completed a step of the
strategy. For example, after reading a paragraph, Gary would underline the main idea of a
paragraph, circle the details, and briefly orally summarize what was read.

Model the Strategy

For strategy instruction to be effective, students must have a strong understanding of why
they use a strategy, how the strategy can help them, and die reasons behind the steps of
the strategy. This information is critical if the students are to see the benefit in using the
strategy. To provide this information, the instructor should model the use of the strategy.
Systematic modeling is a critical component of effective strategy instruction, much more
than simply going through the steps of a strategy; good modeling allows the student to
see the thought processes of a skilled learner as s/he uses the strategy. This modeling
provides critical information on using the RAP strategy (Schumaker et al., 1984), such as
why steps are performed and how the steps help them to become a better reader.
Modeling helps struggling learners understand that using a strategy is not a passive
process, but requires active thought and effort. The procedure used to model a strategy is
referred to as a think-aloud. In this procedure the instructor demonstrates the use of the
strategy while verbalizing his or her thought processes (see box, "Think-Aloud for the
RAP Strategy").

When teaching strategies like RAP (Schumaker et al., 1984), it is important to explicitly
teach and model both the strategy and the self-regulation components of the strategy. The
SRSD model (Harris & Graham, 1996) is designed to include self-regulation strategies
such as self-instructions. In our example think-aloud, we have included self-instructions
that help students to literally talk themselves through the strategy and reading process. As
part of learning the RAP strategy, students should be taught and shown that specific self-
statements and self-instruction can help them cope with negative thoughts and get
through the strategy. For example, statements such as "If I use my strategy and try hard, I
know I can understand what I'm reading" or "I can do this" could be included in the
think-aloud.

Support the Strategy

The support stage of teaching a strategy is a collaboration between the instructor and
student. At this stage, students should know the steps of the strategy; however, they will
still require practice in using the strategy before mastering it. This stage uses scaffolded
instruction to help the student learn to use the strategy independently. During this stage
the instructor and student practice using the strategy. At first, the instructor should
support the student through all the steps of the strategy. As the student becomes more
comfortable with the strategy, instructor support is systematically reduced. Progress
through this stage of the SRSD model (Harris & Graham, 1996) is dependent upon the
length of time needed by the individual student. The instructor should decrease support
and give students more responsibility for the strategy as they are ready. The end result of
this stage should be independent use of the strategy.

Scaffolding can occur at any stage in the SRSD process. For example, in Stage 1 , we
provided the students with a strategy prompt sheet to help remember die steps of die RAP
strategy. Other scaffolding activities occur during instruction and practice activities. For
example, scaffolding instruction could begin with reading a story aloud to the student.
Students should be allowed and encouraged to perform any steps of die strategy
independently; similarly, instructors should support students as needed in any areas of the
strategy. At this stage, supports such as graphic organizers can help students remember
the steps of the strategy, although both prompts and graphic organizers should be faded as
students gain fluency with die strategy. After reading the story aloud, ask die student to
identify the main idea and details in each paragraph by underlining, highlighting, or
saying them aloud. After this step, the instructor should encourage the student to
determine whether his or her goal (identified in Stage 2) was met and to graph the results.
The instructor should also encourage the student to reflect on how the strategy improved
his or her reading comprehension. For further examples of scaffolding, see Table 3.

Independent Performance

In this stage, the student should be ready to use the strategy without assistance from the
instructor. At this stage, the purpose should be to monitor the student's performance and
ensure proper and consistent use of the strategy. Monitoring academic performance is
critical: The goal of strategy instruction is increased academic performance. The student's
work should show a marked and consistent improvement. There are a number of ways to
monitor performance that are simple and effective, such as unit tests or retells. Teachers
should also watch to see if students distort the strategy or skip steps when using it
independently. If a student modifies a strategy but performance remains high, there is no
cause for concern; many students will adapt the strategy to meet their needs. Changes are
acceptable as long as the student performance remains high. On the other hand, if a
student is performing the strategy correctly and consistently but a high level of
performance is not attained (or maintained) then reteaching the strategy or considering a
different strategy is probably in order. When using the RAP strategy (Schumaker et al.,
1984), the independent performance stage is reached when the student is able to read a
multiple paragraph selection while correctly paraphrasing each paragraph with no
assistance from the instructor.

Motivation and emotion are important factors in strategy instruction using SRSD (Harris
& Graham, 1996). Changing a student's attitude toward a task and success are important
goals of strategy instruction. In our case, we observed whether the students' attitudes
toward reading and confidence in theiir abilities improved. We also checked to see if the
students were using the strategy outside the classroom. We observed one student teaching
her classmates the RAP strategy. The use of open-ended questions such as "What do good
readers do?" or "What do you say to yourself before you read something?" can help
teachers determine if a strategy changed students' perception of a task. However, teachers
should remember that some changes (such as attitude improvements) take more time than
others to obtain.

Final Thoughts

The RAP strategy (Schumaker et ah, 1984)- when correctly taught using an effective
model of strategy instruction such as SRSD (Harris & Graham, 1996)- can be extremely
effective for improving reading comprehension. This strategy is extremely flexible and
can be used for elementary, middle, and high school students across many different
content areas (Hagaman & Reid, 2008). Effective strategy instruction requires using
specific techniques (e.g., modeling, scaffolding). Teachers should also remember that
strategy instruction should be customized to the student. Instruction should continue until
die student has mastered the use of the strategy (i.e., using the strategy correctly and
consistently). The number of lessons depends on how quickly the student is able to
master the strategy. Luckily, most students can master the RAP strategy quickly, typically
in four or five lessons of 20 to 30 minutes. Gary, Betty, and Jean mastered the RAP
strategy in four, three, and five lessons, respectively, that were roughly 20 minutes in
length (for lesson plans, see University of Nebraska Lincoln, n.d.). In sum, the RAP
strategy, when taught using an effective model for strategy instruction, can be an effective
means of improving students' reading comprehension.

References

Caccamise, D., & Snyder, L. (2005). Theory and pedagogical practices of text
comprehension. Topics in Language Disorders, 25, 5-20.

Fuchs, L. S., Fuchs. D. F., Hosp, M. K., & Jenkins, J. R. (2001). Oral reading fluency as
an indicator of reading competence: A theoretical, empirical, and historical analysis.
Scientific Studies of Reading, 5, 239-256.
Gajria, M., Jitendra, A. K., Sood, S., & Sacks, G. (2007). Improving comprehension of
expository text in students with LD: A research synthesis. Journal of Learning
Disabilities, 40, 210-225.

Gathercole, S. E., Alloway, T. P., Willis, C., & Adams, A. (2006). Working memory in
children with reading disabilities. Journal of Experimental Psychology, 93, 265-281.

Good, R. H., & Kaminski, R. A. (2002). Dynamic indicators of basic early literacy skilb
(6th ed.). Eugene, OR: Institute for the Development of Education Achievement.

Hagaman, J. L., Casey, K. J., & Reid, R. (in press). The effects of the paraphrasing
strategy on the reading comprehension of young students. Remedial and Special
Education.

Hagaman, J. L., & Reid, R. (2008). The effects of the paraphrasing strategy on the
reading comprehension of middle school students at risk for failure in reading. Remedial
and Special Education, 29, 222-234.

Harris, K. R., & Graham, S. (1996). Making the writing process work: Strategies for
composition and self-regulation. Cambridge, MA: Brookline Books.

Katims, D. S., & Harris, S. (1997). Improving the reading comprehension of middle
school students in inclusive classrooms. Journal of Adolescent and Adult Literacy, 41,
116-123.

Meisinger, E. B., Bradley, B. A., Schwanenflugel, P. J., Kuhn, M. R., & Morris, R. D.
(2009). Myth and reality of the word caller: The relation between teacher nominations
and prevalence among elementary school children. School Psychology Quarterly, 24,
147-159.

Miller, W. H. (1993). Complete reading disabilities handbook: Ready-to-use techniques


for teaching reading disabled students. New York, NY: Center for Applied Research in
Education.

National Reading Panel. (2000). Teaching children to read: An evidence-based


assessment of the scientific research literature on reading and its implications for reading
instruction. Washington, DC: National Institute of Child Health and Human Development
and U.S. Department of Education.

Pressley, M., Brown, R., El-Dinary, P. B., & Allferbach, P. (1995). The comprehension
instruction that students need: Instruction fostering constructively responsive reading.
Learning Disabilities Research & Practice, 10, 215-224.

Reid, R., & Lienemann, T. O. (2006). Strategy instruction for children with learning
disabilities. New York, NY: Guilford.
Schumaker, J. B., Denton, P. H., & Deshler, D. D. (1984). The paraphrasing strategy.
Lawrence, KS: University of Kansas.

Shankweiler, D., Lundquist, E., Dreyer, L. G., & Dickinson, C. C. (1996). Reading and
spelling difficulties in high school students: Causes and consequences. Reading and
Writing: An interdisciplinary Journal 8, 267-294.

Swanson, H. L, Howard, C. B., & Saez, L. (2007). Reading comprehension and working
memory in children with learning disabilities in reading. In K. Cain & J. Oakhill (Eds.),
Children's comprehension problems in oral and written language: A cognitive perspective
(pp. 157-185). New York, NY: Guilford.

University of Nebraska-Lincoln, (n.d.) Cognitive strategy instruction. Retrieved from


http://www.unl.edu/csi/

U.S. Department of Education. (2003). National assessment of educational progress


(NAEP). Washington, DC: Author.

Vaughn, S., Levy, S., Coleman, M., & Bos, C. (2002). Reading instruction for students
with LD and EBD: A synthesis of observation studies. The Journal of Special Education,
36, 2-13.

Jessica L. Hagaman (Wisconsin CEC), Assistant Professor, Department of Special


Education, University of WisconsinWhitewater. Kati Luschen (Nebraska CEC), Doctoral
Student: and Robert Reid (Nebraska CEC), Professor, Department of Special Education
& Communication Disorders, University of Nebraska-Lincoln.

Correspondence concerning this article should be addressed to Jessica L. Hagaman,


University of Wisconsin-Whitewater, Department of Special Education, 800 Main Street,
Whitewater, Wl 53190 (e-mail: hagamanj@ uww.edu).

TEACHING Exceptional Children, Vol. 43, No. 1, pp. 22-29.


Fig. 1 RAP Strategy Cue Card

The RAP Strategy


Read a paragraph.
Ask yourself, What was the main idea
and two details?
Put information into your own words.
(Partner the first 4 or five times).
Table 1. SRSD Stages in RAP Strategy

SRSD Stage RAP Activity

Develop background knowledge Make sure the student knows what main
ideas and supporting details are in a
paragraph.
Sell the RAP strategy as a trick to help
Discuss the strategy with reading comprehension.

Discuss current level of performance with


the student.

Discuss the different steps of the RAP


strategy.

Obtain a commitment to learn and use the


strategy.

Model the strategy Model the use of the RAP strategy using a
think-aloud, demonstrating the hows and
whys for each step.

Memorize the strategy Students memorize the strategy steps.


Automaticity and fluency of strategy steps
frees attention for understanding of text.

Support the strategy Teacher supports the strategy through


scaffolding. Responsibility for strategy use
is gradually transferred to the students.
Student can use strategy independently.
Independent performance
Teacher monitors performance.

Note. SRSD = self-regulated strategy development model (Harris & Graham, 1996); RAP
= Read-Ask-Paraphrase reading strategy (Schumaker, Denton, & Deshler, 1984).

Table 2. Effective Goal Setting

Effective goals should be.

Specific Goals must be specific so students know


exactly what they hope to accomplish the
goal. For example, Get 75% on the
weekly History quiz is specific, whereas
Improve my score on the weekly History
quiz. Is too vague.

Proximal Goals that can be met in the near future are


more effective than those set farther in the
future. Students feel a sense of
accomplishment when they reach a goal,
which motivates them to keep improving
their performance.

Challenging Goals that are too easy do not enhance


student effort; those that are too difficult
can be discouraging. Goals that are
challenging are those that are attainable,
but require effort. Take care when setting
goals, because students often will propose
goals that are too easy or too difficult.
Table 3. Scaffolding Examples

Type of Scaffolding Explanation RAP Example


Instructor uses materials at The student is allowed to
Content scaffolding an easy reading level (e.g., read one paragraph, a
text below the students shorter story or a story
grade level). written at a lower grade
level.
Instructor uses content of
interest to the student to The student reads stories on
teach the strategy. topic(s) that they know
about or interests them.
Instructor teaches the
student easier steps of the The instructor teaches the
strategy first, then moves on student the R and A in RAP
to more difficult steps. first, then how to
paraphrase.
In initial practice sessions
the student performs the
easy steps; the instructor
models the more difficult
steps.
Ownership of the strategy is Phase 1: The instructor asks
Task scaffolding gradually transferred from the student to name the
instructor to student by strategy step that should be
letting the student perform performed, then the
more and more of the instructor describes the step
strategy. and performs it.

Phase 2: The teacher asks


the student to name the step
and describe the step; the
instructor performs the
steps.

Phase 3: The student names,


describes, and performs the
step.

Material scaffolding Prompts, graphic The student is given a


organizers, and cues are graphic organizer or cue
used to help the student use card. As the student gains
the strategy. Typically, mastery of the strategy, the
these are faded over time. prompts should be faded.

Note. RAP = Read-Ask-Paraphrase reading strategy (Schumaker, Denton, & Deshler,


1984).

Figure 2. Sample Goal-Setting Chart

Progress Monitoring

100 100 100 100 100

90 90 90

80 80 80 80 80 Goal 3

70 70 Goal 2 70 Goal 2 70

60 60 Goal 1 60 60 60

50 50 50 50 50

40 40 40 40 40

30 30 30 30 30

20 20 20 20 20

10 10 10 10 10

Baseline Lesson 3 Lesson 4 Lesson 5 Lesson 6


digitalcommons.unl.edu/cgi/viewcontent.cgi?article=1061&context=cehsdiss

This is the link to the 65 page document that the article uses to support evidence of best
practices.

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