Treatment of Dyslexia in a Regular Orthography: Efficacy and Efficiency (Cost-Effectiveness) Comparison Between Home vs Clinic-Based Treatments

The outcomes of three treatments for dyslexia, one clinic-based and two home-based, were compared using a quasi-experimental design for their efficacy and efficiency in improving accuracy and fluency in reading in a large sample of Italian students. The efficacy comparison was based on gain scores in fluency and accuracy of reading texts, and lists of words and nonwords. The efficiency (cost-effectiveness) comparison was based on the ratio of gain scores to the number of hours of treatment. Efficacy and efficiency measures yielded very different results. The efficacy comparison showed a clear superiority of the clinic-based treatment over home-based treatments. The efficiency comparison, on the other hand, showed the superiority of a home-based treatment. The importance of considering both efficacy and cost-effectiveness in any comparison of treatment outcomes is discussed within the framework of the dissemination of evidence-based treatments.