Learning Disabilities: A Contemporary Journal 19(1), 1-22, 2021 Copyright @ by LDW 2021

Evidence-Based Systematic Review of Literature

on Algebra Instruction and Interventions for
Students With Learning Disabilities
Erin Bone
Emily Bouck
Sara Witmer
Michigan State University

It is imperative teachers use evidence-based practices to instruct all

learners. Yet, there are limited reviews focused on educational practices
to support secondary students with learning disabilities in algebra. This
evidence-based systematic review focused on research published in peer
review journals between 1999 and 2019. Eighteen studies across 17 ar-
ticles were reviewed and analyzed, of which 14 met the Council of Ex-
ceptional Children standards of high quality. Researchers identified eight
mathematical instructional approaches to teach algebra related content
to secondary students with learning disabilities. The main result was
that no instructional approach met the necessary criteria to be consid-
ered evidence-based for this particular demographic and mathematical
content. However, five mathematical practices (i.e., CRA, manipulatives,
enhanced anchor instruction, schema based instruction, and peer assisted
learning strategy) were found to be potentially evidence-based.
Keywords: algebra, evidence-based practice, students with disabili-
ties, learning disabilities

Introduction
Algebra is considered by many to be the mathematical gatekeeper, and mas-
tering algebra skills gives students a passport to educational opportunities and an
expansive job market (Ralston et al., 2018). Although often conceptualized as a stand-
alone course, algebra is a strand of mathematics requiring a set of skills used across
topics (Ralston et al., 2018; Stephens et al., 2015). Basic algebraic reasoning includes
such problems as 3+2 = ___, with more complex algebra studied at the secondary
level involving multiple steps and imaginary numbers [e.g., 4(3m – 7) = 2(6 + 9m)].
Algebra may include the manipulation of numbers and symbols to solve for an un-
known, identifying and analyzing patterns, examining relationships, making gener-
alizations, and interpreting change (National Council of Teachers of Mathematics
[NCTM], 2000; Stephens et al., 2015).
According to the NCTM Standards (2000) and the Common Core State
Standards for Mathematics (CCSSM, 2010), algebraic reasoning should be incor-
porated into all grade levels. Foundations of algebra are introduced upon entering
school and students begin by developing fluency with numbers, exploring structure
in operations, and describing relationships (Kieran, 2014; Stephens et al., 2015). Stu-
dents build on these skills every year and should learn to express algebraic relation-
ships symbolically using appropriate mathematical language by middle school. This

*Please send correspondence to: Emily Bouck, Ph.D.,College of Education, Michigan State University, Hannah
Administration Building, 426 Auditorium Road, East Lansing, MI, Phone: (517) 355-1855, Email: [email protected].
Learning Disabilities: A Contemporary Journal 19(1), 1-22, 2021

includes solving basic expressions and equations, analyzing patterns between inde-
pendent and dependent variables, and solving both real-life and mathematical prob-
lems using numerical and algebraic knowledge (CCSSM, 2010). Once students enter
high school, they are challenged to create and reason with equations, inequalities, and
systems of equations at an even more advanced level (Kieran, 2014).
There are several unique challenges associated with learning algebra. To be-
gin, algebra requires a considerable amount of abstract thinking and in order to fur-
ther advance their mathematical understanding, students must learn to navigate the
gap from concrete to abstract reasoning (Stephens et al., 2015; Witzel, 2016). Further,
language plays an integral part in gaining proficiency in mathematics, and the nov-
elty associated with algebra creates additional challenges (Witzel, 2016). Specifically,
assigning appropriate meaning to symbols is difficult for some students. For this rea-
son, it is important to generate opportunities for students to practice using algebraic
language as they converse about strategies, concepts, and mathematical procedures
(Star et al., 2015). Finally, many students struggle to recognize and understand the
structural characteristics of algebra (Star et al., 2015). For example, often students
believe a variable can only stand for one number, instead of recognizing it could
represent a large set of values. Each challenge creates barriers as students work to
develop their algebraic thinking and strategies. While these challenges can be dif-
ficult for all students, they are especially demanding for students with learning dis-
abilities (Star et al., 2015).

Algebra and Students with Learning Disabilities

When analyzing questions involving algebra (i.e., understanding of pat-
terns, using variables, algebraic representation, and functions) on the National As-
sessment of Educational Progress (NAEP, 2019), students with disabilities scored an
average of 40 points lower as compared to their same-aged peers without disabili-
ties (NAEP, 2019). The average for eighth-grade students with disabilities was below
the score for basic on the NAEP, while the average for students without disabilities
was above basic but below proficient. Previous researchers also suggested students
with learning disabilities can face challenges in algebra due to difficulties with work-
ing memory and organization (Scanlon, 2013), representing the algebraic problem
(Maccini & Ruhl, 2000), as well as recall of basic facts or computational processes
(Maccini & Hughes, 2000). In order to close the gap between students with learning
disabilities and those without, it is imperative teachers use effective teaching strate-
gies to give students with learning disabilities access to and support with the general
education curriculum, such as algebra (CCSSM, 2010; Stevens et al., 2018). One way
to determine effective—or evidence-based practices—for teaching algebra is through
systematic reviews of the literature or evidence-based practices syntheses (Cook et al.,
2014; Witzel, 2016).
Within the last decade, researchers conducted three systematic reviews fo-
cused on effective mathematical practices to teach algebra-related content to students
with disabilities (Hughes et al., 2014; Hwang et al., 2019; Watt et al., 2016). Hughes
and colleagues (2014) limited their analysis to quasi-experimental and experimen-
tal designs, and included more than peer-reviewed articles (e.g., dissertations). They
analyzed 12 manuscripts including 13 different studies spanning from 1983-2013.

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 Learning Disabilities: A Contemporary Journal 19(1), 1-22, 2021

Participants included students with disabilities, with three studies involving elemen-
tary students and 10 studies focused on secondary students. Researchers identified
six intervention categories: (a) cognitive/model-based instruction, (b) co-teaching,
(c) concrete-representational-abstract (CRA) framework, (d) graphic organizer, (e)
single-sex interventions, and,(d) technology. All intervention categories had a posi-
tive effect on algebra achievement, except single-sex interventions. However, only
two categories—cognitive/model-based instruction and the CRA framework—had
enough information to calculate a weighted effect size. Both practices indicated mod-
erate effects on students’ algebra achievement and included systematic and explicit
instruction as part of the intervention.
Watt et al. (2016) included only students with identified learning disabilities
and expanded on the previous review by Hughes et al. (2014) by including single-
case design along with quasi-experimental and experimental design. Although their
search for articles meeting criteria spanned 1980-2014, the publication dates of stud-
ies that met the inclusion criteria were limited to 2000-2014. In all, they reviewed 15
studies, including five single-case and 10 group design. Watt et al. suggested large
effects from the interventions, but often an intervention package was used making
individual interventions difficult to disentangle. They identified five interventions
that constituted the majority of research regarding algebra and students with learn-
ing disabilities. Some interventions were consistent with the findings by Hughes et al.
(2014), such as the CRA framework, cognitive strategy or modeling-based instruc-
tion, and graphic organizers. In addition, Watt et al. also suggested researchers have
examined enhanced anchor instruction and tutoring to support the learning of alge-
bra by students with learning disabilities. All of the studies included in the review by
Watt et al. used explicit instruction as part of the intervention, and all but three used
some type of visual representation.
Hwang et al. (2019) also focused on students with learning disabilities—
with attention to secondary students—but examined problem solving and cogni-
tive processes relative to algebra. Hwang et al. (2019) identified 11 studies focused
on middle school students with learning disabilities involving algebra. Across the 11
studies, four cognitive processes emerged: the CRA, the virtual-abstract (VA), the in-
tegrated CRA (CRA-I), and solely abstract. Across all the studies, Hwang et al. (2019)
concluded the interventions were effective and that researchers explicit instruction
was used throughout the studies.

Purpose of the Study

Due to the importance of using evidence-based practices (EBP) to teach
mathematics to students with learning disabilities, there has been an increase in sys-
tematic reviews exploring instruction used to support students with disabilities in
general—and learning disabilities in particular—in the area of mathematics (e.g.,
Bouck et al., 2018; Hughes et al., 2014; Hwang et al., 2019; Marita & Hord, 2017;
Watt et al., 2016). However, two reviews exist in the last ten years that focus explicitly
on effective algebraic instruction for students with learning disabilities (Hwang et
al., 2019; Watt et al., 2016). Yet, neither examined the quality of the studies in com-
parison to quality indicators and standards relative to determining evidence-based
practices. The aim of this evidence-based synthesis was to identify and critically ana-

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Learning Disabilities: A Contemporary Journal 19(1), 1-22, 2021

lyze the practices for teaching secondary school appropriate algebraic concepts to
secondary students with learning disabilities. By applying the quality indicators and
practice standards set by the Council for Exceptional Children (CEC, 2014; Cook et
al., 2014) to the current research base, the authors sought to identify EBP in teaching
algebra to secondary students with learning disabilities. The research questions in-
cluded: (a) What educational practices have been used to teach algebra to secondary
students with learning disabilities? (b) According to CEC standards, which of these
educational practices used to teach algebra to secondary students with learning dis-
abilities are evidence-based?

Method

Literature Search
This evidence-based synthesis focused on research regarding algebraic in-
struction and students with learning disabilities. To begin, the authors conducted a
keyword search of existing databases. Specifically, the authors searched three databas-
es: ProQuest, EBSCOhost, and Google Scholar. Search terms were chosen to identify
studies focused on practices used to teach algebraic content to students with learning
disabilities. The author used a combination of different search terms in an effort to
obtain all available research in this area: (algebra OR linear equations OR equations
OR systems of equations OR expressions OR multi-step equations) AND (high-in-
cidence disabilit* OR mild disabilit* OR learning disabilit*) AND (teach OR learn
OR support OR intervention OR instruction). The authors also conducted similar
searches in the following journals: Exceptional Children, Journal of Special Education,
Remedial and Special Education. Finally, the authors conducted ancestral searches of
accepted articles as well as reviewed the included articles of systematic reviews fo-
cused on secondary students and mathematics (e.g., Marita & Hord, 2017; Watt et al.,
2016) published within the time period.
The search was restricted to articles published in English in a peer-reviewed
journal between 1999 and 2019. The authors limited articles to the last twenty years to
ensure practices being evaluated were still relevant to current educational standards
(Sahlberg, 2016). Two hundred and four articles were initially identified through
searches; an additional 10 articles were screened through the ancestral search. Each
was screened for adherence to inclusion criteria: (a) one dependent variable relative
to algebra learning or skill acquisition described under the Expressions and Equa-
tions (Grades 6–8) or Algebra (Grades 9–12) domains of the CCSS; (b) target popu-
lation as students with learning disabilities (LD); (c) conducted with students en-
rolled in sixth through 12th grade; (d) involved a single case design (SCD) or a group
comparison design; (e) results could be disaggregated for students with disabilities,
(f) the instruction delivered in English; and (g) the impact could be connected to an
algebra instruction. Researchers excluded studies if they did not meet the inclusion
criteria. For example, articles were included if (a) students were in grades PK-5 or
out of school; (b) the target mathematics was not algebra; (c) the results were not
disaggregated for students with disabilities or the impact of an algebraic instruction;
(d) the group design involved a pretest/posttest, meaning there two groups were not
compared; and (e) the study was a secondary analysis of a previously included study.

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 Learning Disabilities: A Contemporary Journal 19(1), 1-22, 2021

Further, articles were excluded if they addressed related, foundational, or precursor

content to learning algebra (e.g., fractions, proportional reasoning), but not linear or
advanced algebraic concepts explicitly. The screening was done by examining the title
and abstract and—if needed–the entire article for eligibility or exclusion.
After applying the screening procedures, 18 studies (17 articles; one article
included two studies) met all inclusion criteria. Once the studies were identified, the
researchers recorded the study characteristics. Study characteristics included: (a) study
descriptions (e.g., title, author, and date of publication), (b) sample (e.g., number of
participants, age or grade), (c) participants’ identified disability or inclusion criteria,
(d) the mathematical content, (e) the instruction used to teach the algebraic concept,
(f) the measure used to evaluate the effectiveness of the instruction (design), and (g) the
results of the study.

Coding for Quality

In quantitative research, methodological rigor refers to the precision of a
study in terms of design, data collection, analysis, and distribution of results (Cook
& Cook, 2013; Cook et al., 2014). To establish methodological rigor in the 18 stud-
ies that met inclusion criteria, the author used specific quality indicators identified
and categorized by the CEC (Cook et al., 2014). The categories included: (1) context
and setting; (2) participants; (3) instructional agent; (4) description of practice; (5)
implementation fidelity; (6) internal validity; (7) outcome data/dependent variable;
(8) data analysis. Each category included anywhere from one to nine specific quality
indicators based on the type of study (i.e., SCD or group). A majority of the quality
indicators were the same for both SCD and group design, however some variation
existed. For instance, internal validity was assessed using different quality indicators
for each design, and group design also had an additional quality indicator related to
outcomes and data analysis. Thus, 22 quality indicators applied to SCD studies and
24 quality indicators to group studies (Cook et al., 2014). Using these standards, a
study is methodologically sound only if it meets all of the quality indicators for the
specified research design (Cook et al., 2014).
When assessing the study for quality using the indicators proposed by the
CEC, the reviewers first determined whether the authors provided sufficient infor-
mation when describing the setting. This includes describing the general location
like the geographic location and community characteristics such as socioeconomic
status, as well as more specifics about the space being used for the instruction. For
a school this may include whether it is public or private, the type of program and/
or physical layout of the classroom (Cook et al., 2014). Next, the reviewers assessed
whether authors included adequate information to describe the participants. This
includes relevant demographic information such as specific disability diagnosis and/
or whether the student is at-risk in a particular area (Cook et al., 2014). In a quality
study, authors describe the method used to determine status (e.g., national or state
assessments, teacher nomination, curriculum-based measurement probes).
The reviewers then assessed the presence of the instruction agent, descrip-
tion of practice, and fidelity of implementation. A quality study reports on critical
characteristics of the person or people implementing the instruction including per-
tinent demographics, their background as relevant to the study, and proof they are

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Learning Disabilities: A Contemporary Journal 19(1), 1-22, 2021

appropriately qualified to implement the instruction (Cook et al., 2014). In addition,

each study should provide sufficient information regarding the critical features of the
instruction in a way that it could be replicated by those reading the description. This
includes detailed instructional procedures, instruction agents’ actions, and detailed
explanation of the materials (Cook et al., 2014). If this information is not included,
the study should indicate how the information can be accessed (e.g., cite original
source). The study should use direct reliable measures to evaluate and document pro-
cedures for implementation, including frequency and intensity, regularly throughout
each component of the instruction and for each participant.
Reviewers then checked that authors established internal validity. This is
demonstrated when the researcher manipulates the variable in a consistent manner,
and participants have very limited or no access to the instruction. For single-case
research, researchers should also describe the baseline, and for group studies details
of the control and comparison conditions need to be explained (Cook et al., 2014). In
group studies, assignment to group must be clearly established and described using
one of the following methods: (a) randomly; (b) nonrandomly, but comparison and
interventions groups are matched (c) nonrandomly, but using techniques to mea-
sure and control statistical differences; or (d) nonrandomly, but using a practical cut-
off (Cook et al., 2014). Quality group studies should also demonstrate low attrition
both across groups (i.e., <30% in a 1-year study) and between groups (i.e., ≤10%) or
controlled for by adjusting for those who do not complete the study. In single-case
research, the design selected should control for common threats to internal validity
(e.g., history, maturation, testing), document three demonstrations of experimental
effect at three different points in time, and include a minimum of three data points
during baseline indicating unfavorable results in the absence of an instruction (Cook
et al., 2014).
Quality studies demonstrate adequate psychometrics as they appropriately
apply measures to determine the effect of the instruction on study outcomes. In qual-
ity research, the outcomes are socially important and the study establishes reliability
(e.g., internal reliability, interobserver reliability, test-retest reliability, parallel-form
reliability; Cook et al., 2014). In addition, authors clearly define the study and ade-
quately describe the measurements of the dependent variable, the time and frequency
of data collection are considered appropriate, and all effects of the instruction are
reported and not just those with positive results (Cook et al., 2014). For group meth-
ods, the study should also provide sufficient evidence of validity (e.g., content, con-
struct, criterion, social validity).
Finally, in a quality study, authors use appropriate data analysis and report
effect size. For group studies this includes using techniques capable of analyzing
change in performance of two or more groups and either reporting effect size or
providing the necessary information to calculate effect size (Cook et al., 2014). For
single-case research, a graph or graphs that clearly represent all data collected is nec-
essary in order to determine the effect of the instruction using standard visual analy-
sis procedures (Cook et al., 2014).

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 Learning Disabilities: A Contemporary Journal 19(1), 1-22, 2021

Determination of Evidence-Based Practice

To determine whether identified instructional approaches met criteria to be
considered evidence-based, the author assessed the status of each category of practice.
Based on the CEC standards, instructional approaches are classified as (a) evidence-
based; (b) potentially evidence-based; (c) mixed effects; (d) insufficient evidence; or
(e) negative effects (Cook et al., 2014). For each category, there is set criteria that must
be met and in order to classify practices in special education research, methodologi-
cally sound studies need to report positive, neutral/mixed, or negative effects. Depen-
dent on the research design, number of participants, and ratio of positive to neutral
outcomes, an educational practice may be considered evidence-based with as few as
two methodologically sound studies (Cook et al., 2014).
A practice is considered evidence-based if it meets specific criteria estab-
lished by the CEC. When reviewing group designs, a practice must be supported by
at least two methodologically sound studies including random assignment, positive
results, and at least 60 participants across studies. If non-random assignment is used,
there needs to be at least four studies and 120 participants across studies. When re-
viewing SCD research designs, a practice must be supported by at least five meth-
odologically sound studies with positive effects and at least 20 participants across
studies (Cook et al., 2014). If various research designs are used to evaluate a practice,
it is evidence-based if it meets at least 50% of the criteria for two or more of the
study designs. In addition, there must be at least a 3:1 ratio of studies conducted with
positive results to studies yielding neutral or mixed results. If any of the studies result
in negative effects on students, the practice will not be considered evidence-based
(Cook et al., 2014).
A practice may be considered potentially evidence-based if there are positive
results, but too few high-quality studies. When reviewing group designs, a practice
must be supported by at least one methodologically sound group design with ran-
dom assignment and positive effects. If nonrandom assignment is used, the practice
must be supported by a minimum of two or three methodologically sound group
studies. When reviewing SCD research, the practice must be supported by two to
four methodologically sound SCD research with positive effects (Cook et al., 2014).
If various research designs are used to evaluate a practice, it is considered potentially
evidence-based if it meets at least 50% of criteria for each of the study designs. In ad-
dition, there must be at least a 2:1 ratio of studies conducted yielding positive results
to studies yielding neutral or mixed results. Further, if even one study yields negative
results, the practice will not be considered potentially evidence-based (Cook et al.,
2014).

Interobserver Agreement
Agreement for inclusion of articles in the study and coding of study char-
acteristics were through the consensus of the first author and a doctoral student.
Twenty-five of the original 67 studies (i.e., 37.3%) were coded based on the set crite-
ria by the two reviewers. Interobserver agreement (IOA) was determined by dividing
the number of agreements by the number of agreements plus disagreement. The IOA
was calculated as 97%. When a disagreement occurred, the researchers reviewed cri-
teria and discussed until 100% agreement was reached for both inclusion and study

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Learning Disabilities: A Contemporary Journal 19(1), 1-22, 2021

characteristics. Due to the acceptable IOA, the first author independently coded the
remaining studies to determine inclusion for the review.
All studies that met inclusion criteria were coded independently by the first
and third author for the application of quality indicators (i.e., 100%). The researcher
chose to have all of the studies coded by two people because failure to meet all stan-
dards eliminated the study from being categorized as methodologically sound re-
search. When the coders believed there was not a meaningful threat to validity and
that the design issue was addressed adequately, a study was considered to have satis-
fied a quality indicator (Cook et al., 2014). Each coder recorded a Y when the quality
indicator was met, and a N when the quality indicator was not met. A disagreement
was highlighted red to indicate a need for further discussion. The researcher divided
the number of agreements by the total number of indicators and then multiplied the
quotient by 100 to determine interrater reliability. The IOA for quality indicators was
98.1%. Once the coders discussed the indicators of disagreement they came to agree-
ment on 100% of the indicators and sixteen studies were classified as methodologi-
cally sound.

Results
Eighteen studies (17 articles) met the criteria to be a part of this systematic
review spanning from 1999-2019. One study was published in the 1990s, 13 in the
2000s, and six in the 2010s. All studies focused on algebra-related concepts such as
word problems including algebraic processes, operations with integers, and solving
linear equations. All studies had neutral or positive results, and statistical results indi-
cated moderate to large effects.

Participant Characteristics
Participants were in sixth through twelfth grade. The number of partici-
pants across all studies reported was 449. However, a portion represented peers with-
out disabilities. Of the students with disabilities, participants were identified as hav-
ing various high-incidence disabilities including learning disabilities, disabilities in
mathematics, emotional or behavioral disabilities, ADHD, and mild intellectual dis-
ability. However, the majority of students with disabilities included in the research
were students with learning disabilities. Specifically, 253 students across the studies
were identified, as reported in the included articles, as having a learning disability
(56.4%).

Study Designs
Of the 18 studies, 12 involved single-case research methodology and 6 used
group design methodology (see Table 1 for characteristics and information of in-
cluded studies). Within the SCD studies, one used alternating treatment design, eight
used a multiple probe design, and three used a multiple baseline design. The group
design methodology included two experimental designs and six quasi-experimental
designs. For the quasi-experimental designs, participants were generally assigned to
either a treatment or control group based on their class at school.

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 Table 1. Study characteristics

Study Participants Disability Content Practice Design Results

Bottge et al. (2002) n= 100 LD, EBD, pre-algebra EAI quasi- SWD benefited from EAI and retained a
6-12th grade CD, SL experimental majority of what they learned over time.

Bottge, Rueda, n = 42 LD, EBD pre-algebra EAI quasi- Participants in EAI outperformed TPI group
Laroque et al. 8 SWD experimental on contextual posttest and transfer. No
(2007) 7th grade difference in computation and word problems.
All SWD in EAI group had higher scores
on the word problems, but 75% had lower
computation.
Bottge, Rueda, n = 128 12 LD (1 pre-algebra EAI quasi- Students (inclusive of LD) benefited from
Serlin et al. (2007) 13 SWD ADD) experimental EAI, including students with LD making

9
7th grade comparable progress to students without LD

Bouck et al. (2019) n = 4 ID, LD, linear algebra VA SCD: multiple All four participants acquired the algebra
middle ADHD equations probe across skills, but were unable to maintain skills when
school behaviors instruction was not provided directly before
replicated completing the probe.
across
participants
Calhoon & Fuchs n = 92 LD, EBD, operations PALS quasi- PALS + CBM group outperformed the control
(2003) 9th-12th ID & algebraic experimental group on computation scores.
grade thinking, Both groups increased comparably on
measurement, concepts/applications.
& geometry
Learning Disabilities: A Contemporary Journal 19(1), 1-22, 2021
 Table 1. Study characteristics (continued)

Ives (2007a&b) n = 14 (GO) LD solving graphic experimental Participants who used graphic organizers
n =16 (CG) systems organizer outperformed those who did not when solving
of linear systems of linear equations. In Study 1,
equations participants maintained learning over a couple
of weeks. In Study 2, students had more
success actually solving the problems.
Jitendra et al. n=4 LD word problems SBI SCD: multiple All participants improved word problem–
(2002) 8th grade probe across solving performance and maintained
participant performance over the duration of the
intervention. All participants demonstrated
high scores during generalization.
Jitendra et al. n=4 LD word problems SBI SCD: multiple All participants improved from baseline
(1999) 6th-7th grade baseline across to intervention in using correct operations.

10
participants Participants generalized strategy. 2
Learning Disabilities: A Contemporary Journal 19(1), 1-22, 2021

replicated participants maintained, 1 slightly decreased,

across 1 drastically decreased.
behaviors
Maccini & Hughes n=6 LD problem CRA SCD: multiple Problem-solving skills dramatically improved
(2000) ages 14-18 solving with probe across following instruction at the concrete, semi
integers participant concrete, and abstract levels. Participants’
strategy use increased and they were able to
generalize skills to novel situations.
 Table 1. Study characteristics (continued)

Maccini & Ruhl n=3 LD subtraction of CRA SCD: multiple All participants demonstrated an improvement
(2000) 8th grade integers probe across in strategy use, accuracy on problem
participant representation, and average accuracy on
problem solution from baseline to concrete
instruction. Participants were able to maintain
skills over time, and were able to generalize
to near tasks, but have lower transfer skills for
far generalization.
Satsangi et al. n=3 MLD linear algebraic manipulatives SCD: All participants solved more algebraic
(2016) 11th-12th equations (virtual & alternating questions correctly with both types of
grade concrete) treatment manipulatives. 2 students learned the material
quickest with concrete, and one student
learned quickest with virtual. All 3 students

11
had fewer prompts and completed problems
quicker using virtual manipulatives suggesting
greater independence.
Satsangi et al. n=3 MLD multistep manipulatives SCD: multiple Using virtual manipulatives all participants
(2018a) 9th grade algebraic (virtual) baseline across scored above their baseline scores during
equations participant intervention, maintenance, and generalization.
All participants said they benefited and
enjoyed using the virtual manipulatives.
Satsangi et al. n=3 MLD multistep manipulatives SCD: multiple All participants improved from baseline.
(2018b) 9th grade algebraic (virtual) baseline across Accuracy scores ranged from 70-100% during
equations participants intervention and maintenance. Independence
scores ranged from 78-100% during
intervention and maintenance.
Learning Disabilities: A Contemporary Journal 19(1), 1-22, 2021
 Table 1. Study characteristics (continued)

Scheuermann et al. n = 14 LD one-variable Explicit SCD: multiple All participants made substantial progress, all
(2009) 6th-8th grade equations Inquiry probe across but 1 student reached mastery criterion (80%
Routine (EIR) participant accuracy) by the final instructional probe.
Participants were able to generalize their skills
to new problems written in the same format
and maintained performance for up to 11
weeks.
Strickland & n=3 LD multiplying CRA-I + SCD: multiple All participants substantially increased overall
Maccini (2012) 8th-9th grade linear Graphic probe across accuracy from baseline to intervention.
expressions Organizer participants 2/3 demonstrated mastery level during
maintenance, 1 was improved from baseline,
but not mastery. Participants transferred
info to novel situations but were not able

12
to transfer to higher level mathematics.
Participants reported that they found the
Learning Disabilities: A Contemporary Journal 19(1), 1-22, 2021

intervention beneficial and enjoyable.

Strickland & n=5 LD, MD quadratic CRA-I + SCD: multiple Participants’ accuracy improved and they
Maccini (2013) high school expressions Graphic probe across maintained their skills over time. Participants
within area Organizer two groups reported the intervention was beneficial and
word problems they would recommend it to peers.

Van Garderen n=3 LD word problems Diagrams SCD: multiple Students improved ability to generate
(2007) 8th grade (algebra skills) probe across diagrams and use them to solve 1 and 2-step
participants word problems. Participants generalized
their skills to solve different types of word
problems.

Note: EAI = enhanced anchored instruction, VA = virtual-abstract; PALS = peer-assisted learning strategies CRA = concrete-representational-abstract,
SBI = schema-based instruction
 Learning Disabilities: A Contemporary Journal 19(1), 1-22, 2021

Categories of Mathematical Practice

After analyzing the mathematical practices described in each study, eight
instructional categories emerged: (a) concrete-representational-abstract (CRA)
framework (b) schema-based instruction, (c) enhanced anchor instruction, (d)
manipulatives, (e) peer-assisted learning strategies, (f) virtual-abstract (VA) frame-
work (g) graphic organizers and diagrams; and, (h) explicit inquiry routine. Three
studies explored the CRA instructional sequence, three manipulatives outside of an
instructional sequence, and one virtual manipulative-based sequence. Two studies
investigated schema-based instruction (SBI) and three studies investigated enhanced
anchored instruction (EAI). One study explored peer-assisted learning strategies
(PALS), one the impact of visual displays like graphic organizers and diagrams, and
one study explicit inquiry routine.

Applying Quality Indicators

After applying the criteria established by the CEC, four studies did not meet
the requirements to be considered methodologically sound research. Four of the six
group design studies had all 24 quality indicators (See Table 2) and 10 of the 12
single-case studies had all 22 quality indicators (see Table 3). Studies not meeting
quality indicators included (a) Scheuermann et al. (2009), who did not include ad-
equate implementation fidelity information; (b) Ives (2007), who reported two stud-
ies in one publication with both missing several key indicators including adequate
procedural information, proof of fidelity of implementation, and adequate internal
validity; and (c) Strickland and Maccini (2012), who only included two baseline data
points for one of their participants.
Based on the CEC standards and the 14 studies that met all quality indica-
tors for algebraic instruction and students with high-incidence disabilities, no inter-
ventions met the criteria to be considered evidence-based. All studies yielded neutral
or positive results, but the research base lacked adequate quantity of high-quality
studies for each practice. Five mathematical practices can be considered potentially
evidence-based including: CRA, manipulatives, EAI, SBI, and PALS (see Table 4).
Three quality studies explored the CRA framework and all yielded positive
results. Two studies paired the CRA framework with the problem-solving strategy
STAR (search, translate, answer, review; Maccini & Hughes, 2000; Maccini & Ruhl,
2000), and one modified the CRA strategy to include a graphic organizer during
the abstract phase (Strickland & Maccini, 2013). When only including studies that
explored manipulatives as a stand-alone mathematical tool, and not part of an in-
structional sequence, three SCD studies with nine participants existed. One study
compared concrete and virtual manipulatives and found both to be effective for sec-
ondary students with disabilities (Satsangi et al., 2016), and two paired virtual ma-
nipulatives with explicit instruction and reported a functional relation (Satsangi et
al., 2018a, 2018b).

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 Table 2. Cook et al. (2014) Quality Indicators (QI) Applied to Group Design Algebra Studies Involving Students with Learning Disabilities

1.1 2.1 2.2 3.1 3.2 4.1 4.2 5.1 5.2 5.3 6.1 6.2 6.3 6.4 6.8 6.9 7.1 7.2 7.3 7.4 7.5 7.6 8.1 8.3
*Bottge et al. (2002) Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
*Bottge, Rueda,
LaRoque, et al. Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
(2007)
*Bottge, Rueda,
Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
Serlin, et al. (2007)
*Calhoon & Fuchs

14
Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
(2009)
Learning Disabilities: A Contemporary Journal 19(1), 1-22, 2021

Ives (2007a) Y Y Y Y Y N Y N N N Y N Y N Y Y Y Y Y Y Y Y Y Y

Ives (2007b) N Y Y N N N Y N N N Y N Y N Y Y Y Y Y Y N Y Y Y

Note: Y = yes, quality indicator present & N = no, quality indicator not present. Quality indicators 6.5, 6.6, 6.7, and 8.2 only applied to single case
studies and are not included here. See Cook et al. (2014) for the complete list of quality indicator (e.g., 1.1 – 8.2). Note, Ives (2007a and 2007b) were
reported both in one article

* means the study met all quality indicates

 Table 3. Cook et al. (2014) Quality Indicators Applied to SCD Algebra Studies Involving Students with Learning Disabilities

1.1 2.1 2.2 3.1 3.2 4.1 4.2 5.1 5.2 5.3 6.1 6.2 6.3 6.5 6.6 6.7 7.1 7.2 7.3 7.4 7.5 8.2

*Bouck et al. (2019) Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y

*Jitendra et al. (2002) Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
*Jitendra et al. (1999) Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
*Maccini & Hughes (2000) Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
*Maccini & Ruhl (2000) Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
*Satsangi et al. (2016) Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y

15
*Satsangi et al. (2018a) Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
*Satsangi et al. (2018b) Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
Scheuermann et al. (2009) Y Y Y Y Y Y Y N Y Y Y Y Y Y Y Y Y Y Y Y Y Y
Strickland & Maccini (2012) Y Y Y Y Y Y Y Y Y Y Y Y Y N Y Y Y Y Y N Y Y
*Strickland & Maccini (2013) Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
*VanGarderen (2007) Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y

Note: Y = yes, quality indicator present & N = no, quality indicator not present. Quality indicators 6.4, 6.8, 6.9, 7.6, 8.1, and 8.3 only applied to group
design studies and are not included here. See Cook et al. (2014) for the complete list of quality indicator (e.g., 1.1 – 8.2).

* means the study met all quality indicators.

Learning Disabilities: A Contemporary Journal 19(1), 1-22, 2021
 Table 4. Evidence-Base Categories of Practices

Practice Group Single Participants Random Results Category

Manipulative-Based Approaches 0 7 27 N/A Positive Evidence-based
Enhanced Anchor Instruction 3 0 142 No Positive/Neutral Potentially Evidence-Based

16
Peer-Assisted Learning Strategies 1 0 92 Yes Positive Potentially Evidence-Based
Learning Disabilities: A Contemporary Journal 19(1), 1-22, 2021

Schema Based Instruction 0 2 27/8 N/A Positive Potentially Evidence-Based

Graphic Organizers & Diagrams 0 1 3 N/A Positive Insufficient Evidence
 Learning Disabilities: A Contemporary Journal 19(1), 1-22, 2021

This review included three group designs that investigated EAI. Two of these
studies yielded positive results (Bottge, Reuda, Laroque, et al., 2007; Bottge, Reuda,
Serlin, et al., 2007), while the other had neutral results where participants in the EAI
outperformed the control group and students with disabilities scored better on word
problems using EAI, but their computation skills were lower (Bottge et al, 2002).
Two SCD studies with eight participants (Jitendra et al., 1999; Jitendra et al., 2002)
investigated SBI and one group design with 92 participants explored PALS (Calhoon
& Fuchs, 2003). These three studies yielded positive results categorizing these two
practices as potentially evidence-based.

Discussion
This evidence-based synthesis analyzed the literature on teaching algebra
to secondary students with learning disabilities. Eighteen studies were reviewed and
analyzed, of which 14 met the CEC standards of high quality (Cook et al., 2014).
Across the 18 studies, researchers investigated eight different mathematical instruc-
tional approaches to teach algebra related content to secondary students with learn-
ing disabilities. The main result of the review was that none of these instructional
approaches met the necessary criteria to be considered evidence-based for this partic-
ular demographic and mathematical content. However, five mathematical practices
(i.e., CRA, manipulatives, EAI, SBI, and PALS) were found to be potentially evidence-
based. From this systematic review, educators can make informed decisions about
the instructional practices they use to teach algebra to students with high-incidence
disabilities, and researchers can plan future studies to fill the gaps in literature.
When focusing specifically on instruction to support secondary students
with learning disabilities in the area of algebra, no one instructional approach cat-
egory met the CEC’s (2014) standards of evidence-based. The lack of evidence-based
practice determinations is likely due to a lack of literature on the topic. Researchers
found 18 studies in the past 20 years focused on algebra interventions and instruc-
tional practices to support secondary students with learning disabilities. This number
is relatively small compared to research pertaining to interventions and instructional
practices to support students in reading (Wood et al., 2018) and mathematics inter-
ventions and instructional approaches focused on more foundational content (e.g.,
early numeracy, basic operations; Dennis et al., 2016; Stevens et al., 2018). Further,
there was a decrease in the last decade as compared to the previous decade (almost
double in the 2000s to that in the 2010s). Combined, these findings demonstrates the
need for more high-quality research to be conducted to provide practitioners with
evidence-based practices for teaching algebra to secondary students with learning
disabilities.
Nearly one-fourth of the studies analyzed in this review failed to meet the
standards established by the CEC to be considered methodologically sound (Cook
et al., 2014). CEC’s standards were published in 2014, resulting in the majority of
included studies published before the standards were established. While quality indi-
cators and standards existed previous to this date (e.g., Horner et al., 2005 for single-
case and Gersten et al., 2005 for group), nearly half of the included publications pub-
lished before these earlier quality indicators and standards. In this evidence-based
synthesis, we applied indicators and standards ex post facto to studies published prior

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Learning Disabilities: A Contemporary Journal 19(1), 1-22, 2021

to such guidelines. Further, the CEC quality indicators and standards applied here
may be more rigorous than other options, because they require studies to meet all
quality indicators in order to be considered methodologically sound (Cook et al.,
2014; Cook & Cook, 2013). Applying quality indicators with such high standards
means only the most credible studies are included when determining whether a prac-
tice is evidence-based (Cook et al., 2014; Cook & Cook, 2013). Thus, when a prac-
tice meets evidence standards, practitioners can use it with confidence. However, the
authors also acknowledge the problem when applying quality indicators—they can
only be applied to studies that actually get published. Studies with negative results or
insignificant results are likely not published and hence evidence-based syntheses are
subject to publication bias (Cook & Therrien, 2017).
Five mathematical practices met the criteria for potentially evidence-based:
CRA, manipulatives, EAI, SBI, and PALS. Consistent with previous reviews, the im-
plementation of these instructional approaches yielded positive results for students
with disabilities acquiring algebra skills (e.g., Marita & Hord, 2017; Watt et al., 2016).
A classification of potentially evidence-based means there were too few studies and/or
participants to confirm the effectiveness of the practice (Cook et al., 2014). However,
within the case of EAI and SBI, Bottge and colleagues and Jitendra and colleagues
examined issues related foundational algebra concepts—including fractions and pro-
portional reasoning—but fewer examining algebra as defined in this review. If the re-
view was expanded to include these fundamental concepts, EAI and SBI would likely
be determined EBPs for secondary students with learning disabilities. However, there
is a need for more research focused on algebra and students with learning disabilities
in order to validate that seemingly effective instructional approaches are backed by
multiple sources of high-quality evidence as well as continue to explore the efficacy
of new instructional approaches that take into consideration emerging technologies
and understanding of algebra in mathematics education. Yet, the results offer second-
ary educators options for consideration when teaching algebra, given only practice
could be considered evidence-based for teaching algebra to secondary students with
learning disabilities.
Over one-third of the high-quality studies reviewed involved manipulatives
either as a stand-alone tool (e.g., Satsangi et al., 2016) or as part of a framework (e.g.,
Bouck et al., 2019, Maccini & Ruhl, 2000). If combined, the category of manipulative-
based instructional approaches—inclusive of CRA, VA, and manipulatives—would
have been an evidence-based practice. Yet, the differences of the instructional ap-
proaches within this larger category are great and as such, the authors opted not
to combine or aggreate. However, the potential evidence-base determination for the
CRA and manipulatives aligns with the recommendation of the National Council of
Teachers of Mathematics to use manipulatives for teaching mathematics at all levels
(NCTM, 2013). Further, Bouck et al. (2018) found the CRA to be evidence-based for
students with learning disabilities generally across mathematics, not disaggregated
by domain.

Implications for Practice

The results of this systematic review hold implications for practice. The first
is that there are five potentially evidence-based practices to teach algebra to students

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 Learning Disabilities: A Contemporary Journal 19(1), 1-22, 2021

with learning disabilities. When implemented with fidelity, researchers demonstrated

these practices support student learning in mathematics (Maccini & Hughes, 2000;
Satsangi et al, 2018a). While they are not guaranteed to work for every student, these
mathematics instructional approaches should be a consideration in algebra instruc-
tion decision making for secondary students with learning disabilities (Cook & Cook,
2013). Although secondary students with learning disabilities are making gains in
mathematics, gaps still exist between those with disabilities and those without (NAEP,
2019), thus it is imperative teachers use practices that are shown to be effective for
students with disabilities (NCTM, 2013).
A final implication for practice is the emergent of the use of virtual manipu-
latives to support secondary students with learning disabilities in the area of algebra.
The four most recent studies included in this review involved virtual manipulatives
in some capacity (e.g. Bouck et al., 2019, Satsangi et al., 2018a; Satsangi et al., 2018b;
Satsangi et al., 2016), suggesting virtual manipulatives represent an up-to-date and
relevant practice. Accessible through Chromebooks, iPads, or computers, virtual
manipulatives do not take up extra space in the classroom, allow for individualized
scaffolding within the program, and are often less stigmatizing to older students com-
pared to concrete manipulatives (Satsangi & Miller, 2017). Secondary teachers deliver-
ing math instruction may want to consider using virtual manipulatives during whole
group instruction or for small group interventions targeting specific skill deficits.

Limitations and Future Direction

This evidence-based systematic review is not without its limitations. Al-
though steps were taken to ensure all relevant peer-reviewed research was included,
there is a chance the inclusion criteria excluded literature that could add to the re-
sults and discussion. Further, only peer-reviewed journal articles published in Eng-
lish were considered, leaving out both dissertations and chapters from books. Future
researchers should consider including non-peer-reviewed publications to gather a
larger scope of the existing literature. Regardless, the low number of peer-reviewed
published studies is a call to action for researchers to expand research on algebra in-
terventions and instructional approaches for students with learning disabilities.
Another limitation was that the instructional approaches examined among
studies were sometimes an intervention package (i.e., a combination of instructional
components, such as manipulatives plus explicit instruction) making it difficult to
credit the effects to a single element (e.g., manipulatives; Watt et al, 2016). In some
situations, the intervention or instructional approach was paired with a strategy al-
ready established as evidence-based to teach mathematics to secondary students with
learning disabilities (e.g., National Center on Intensive Intervention, 2016; Satsangi et
al, 2018a). When paring explicit instruction with other practices, like manipulatives,
it is difficult to determine whether the use of the manipulatives or the quality instruc-
tion was the source of success. Future researchers should include direct comparisons
of instructional practices in order to help educators in determining the most effective
evidence-based practices for teaching algebra to students with learning disabilities.
However, the researchers also acknowledge that intervention packages are more likely
to help educators achieve the acquisition, maintenance, and generalization of algebra
they seek to achieve for their secondary students with disabilities (Park et al., 2020).

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Learning Disabilities: A Contemporary Journal 19(1), 1-22, 2021

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