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Abstract
Students who do not show growth from whole class 
(Tier 1) and small group (Tier 2) reading fluency 
interventions, may require one-on-one interventions 
that are designed to support the development 
of fluent oral reading. The authors of this article 
reintroduce the Neurological Impress Method (NIM) 
and provide a research-based protocol and practical 
recommendations for implementation. Existing 
research on the NIM provides evidence for giving 
it another chance for one-on-one reading fluency 
interventions.

Sophia is a fifth-grade student who is below grade 
level in reading. Her teacher, Mrs. Smith, is concerned 
because Sophia is very disfluent in her oral reading 
and often labors through text when reading aloud. 
Mrs. Smith asks students to read aloud a grade level 
passage with a partner, as a part of the core literacy 
instruction. She notices that Sophia is stumbling over 
words and appears visibly upset. Sophia begins to turn 
red and reads with a shaky voice. Fearful that Sophia 
is on the verge of crying, Mrs. Smith has a private 
conference with her to find out what is wrong. Sophia 
tells Mrs. Smith that she hates reading aloud in class 
because she thinks she ‘sounds like a baby’. Sophia 
feels like everyone in the class is staring at her when 
she reads because she does not read smoothly. Mrs. 

Smith knows grade level text is too difficult for Sophia, 
so she provides lower level passages to practice oral 
reading fluency. She is baffled because Sophia’s oral 
reading fluency is improving when she reads text at 
a lower level, but when Sophia reads grade level text 
she struggles. In addition to Tier 1 support, Sophia is 
receiving Tier 2 structured reading interventions, but 
Mrs. Smith doesn’t know how to further support her 
oral reading development when reading grade level 
material in class.

Many teachers may find that they are in the same 
position as Mrs. Smith, unable to support struggling 
students with reading aloud grade level texts. The 
scenario described above was based on personal 
experiences, as described by the teacher in that fifth-
grade classroom. Sophia is pseudonym of a student 
participating in the NIM in the present study. These 
reading challenges may impact students receiving 
support through Response to Intervention (RtI) as 
well as students identified with disabilities, especially 
when they have prolonged documented deficiencies 
in oral reading fluency. The Report of the National 
Reading Panel (NRP )(2000) defined fluency as the 
ability “to read orally with speed, accuracy, and proper 
expression” (p. 193). Students struggling with fluency 
need guided instruction using oral reading techniques. 
The purpose of this article is to reintroduce the 

Give the 
Neurological 
Impress 
Method 
Another 
Chance for 
One-to-One 
Fluency 
Interventions
by MeLiSSa M. MitcheLL anD
Dr. VaSSiLiki ZygouriS-coe



GEORGIA JOURNAL OF READING 7 VOLUME 41, NUMBER 1   2018

Neurological Impress Method (NIM) as a viable 
strategy to support guided practice of oral reading as 
a one-to-one intervention for students struggling with 
fluency. This article also includes a description of the 
NIM in action in a fifth-grade classroom. This easy to 
implement strategy is appropriate for disfluent readers 
who, like Sophia, have failed to make progress in 
developing oral reading fluency after receiving Tier 
1 and 2 interventions, as one part of a structured 
intensive intervention or in addition to a structured 
reading intervention.

Struggling Readers in an Era  
of New Educational Policies
The context surrounding struggling readers, relating 
to educational policy, has a vital impact on the 
implementation of any instructional practice or 
intervention. The 2004 reauthorization of Individuals 
with Disabilities Education Improvement Act (IDEIA) 
brought forth many changes in literacy instruction. Prior 
to implementation, poor readers were often identified 
as having a “specific learning disability” (SLD) through 
an IQ test. This widely implemented practice failed to 
predict how well a child would respond to intervention, 
even though research showed a positive response 
to early effective intervention (Johnston, 2011). One 
transformation that developed from IDEIA was a 
Response to Intervention (RtI) framework, bringing a 
critical change in how educators respond to struggling 
readers (Hawkins, Marsicano, Schmitt, McCallum, 
& Musti-Rao, 2015; Yell, 2006). Educators are now 
required to provide intensive interventions supported 
with scientific evidence, with regular progress 
monitoring to ensure effectiveness of instructional 
practices, while also ensuring instructional practices 
align to weak areas in reading proficiency. Educators 
may find this task to be even more challenging as 
expectations for student achievement increase.

The most recent change to educational policy came 
from the implementation of the Common Core State 
Standards (CCSS) initiative (National Governors 
Association Center for Best Practices, Council of 
Chief State School Officers [NGA & CCSSO], 2010). 
Demands for student achievement in literacy have 
increased drastically. According to the CCSS for 
English Language Arts and Literacy Standard 10 
(i.e., Range, Quality, & Complexity), students are 
expected to have regular practice with complex text 
and academic language. Schools have been making 
CCSS-related instructional shifts to prepare students 
for the increased demands of complex text and the 
need for them to develop deep levels of comprehension 
that go beyond literal and inferential understanding. 
Main shifts resulting from new educational standards 
include (a) regular practice with complex texts and 
academic language; (b) reading, writing, and speaking 

grounded in evidence from texts, both literary and 
informational; and, (c) building knowledge through 
content-rich nonfiction. In the midst of all of these shifts 
and in states’ efforts to best prepare students for new 
assessments, reading fluency seems to have taken a 
back seat. Keeping up with ever-changing educational 
policies could make it challenging to identify and 
implement best practices in literacy instruction and 
intervention (Papola-Ellis, 2014).

Why Fluency?
Reading fluency enables the reader to invest energy 
in meaning-making instead of on decoding (Rasinski, 
2006). The NRP (2000) found that students struggling 
with disfluent reading were at higher risk for reading 
comprehension difficulties. According to the 2015 
report from National Assessment of Educational 
Progress (NAEP), 36% of students scored proficient 
or above on the 4th grade reading assessment, 
while 34% of eighth grade students scored proficient 
or above, showing that many students tested in the 
nation cannot read at a proficient level. In their study, 
Valencia and Buly (2004) found fluency to be a 
contributing factor to students’ lack of proficiency on 
state standardized reading assessments.

There are several schools of thought on the 
relationship between fluency and comprehension. 
According to Young et al. (2015), the relationship 
between disfluent reading and low standardized 
assessment scores can be explained by LaBerge’s 
and Samuel’s (1974) Theory of Automatic Processing. 
As the theory suggests, when students decode word-
by-word lacking automaticity, or the ability to quickly 
recognize words without effort, they may lack the 
cognitive ability to focus attention on the processes 
needed for comprehension.

Automaticity may not be the only factor in fluency’s 
impact on reading comprehension as prosodic reading 
is also necessary. Educators can relate prosody to 
a reader’s variation in loudness and pitch as well 
as duration and pauses in oral reading (Benjamin, 
& Schwanenflugel, 2010; Kuhn, Schwanenflugel, 
& Meisinger, 2010). Some think of prosody as a 
byproduct of oral reading, but studies suggest readers 
hear an inner voice while reading and use expression 
to aid in comprehension (Rasinski & Young, 2014). 
Development of prosodic, fluent reading is vital for 
students to master comprehension skills needed to be 
successful on CCSS (NGA & CCSSO, 2010).

How is Fluency Developed?
Most researchers agree fluent reading is developed 
through practice of oral reading techniques (Anderson, 
1981). However, there is some disagreement regarding 
the most effective methods for the development 



GEORGIA JOURNAL OF READING 8 VOLUME 41, NUMBER 1   2018

of fluency (NRP, 2000). Several popular methods 
are echo reading, assisted reading, choral reading, 
repeated reading, and wide reading.  In echo reading, 
the student echoes or repeats a portion of text read 
aloud by the teacher. Another popular method is 
choral reading, students and the teacher read text 
in unison, usually in a whole group or small group 
setting. In assisted reading, the child and adult read 
aloud portions of text together, either in an echo format 
or in a choral reading (Anderson, 1981). Research 
has shown the practice of repeated reading, using 
a range of texts with classroom practice, increases 
oral reading fluency for disfluent readers (Boulay, 
Goodson, Frye, Blocklin, Price, & National Center 
for Education Evaluation and Regional Assistance, 
2015). In repeated reading, a student will reread a 
text either a predetermined number of times or until 
fluency is achieved, with regular corrective feedback 
from the teacher (Samuels, 1979). Allington (2014) 
makes the argument that wide reading, reading large 
volumes of texts across topics and genres, increases 
all areas in reading proficiency, including fluency. 
These techniques have a long history, but are they 
sufficiently assisting students who struggle with 
fluency in building the foundational skills needed to 
master current educational standards? 

Reading Interventions
What about students who continue to struggle with 
fluent reading despite receiving support in Tier 1 
instruction? The first step in helping these students 
is through early identification of reading difficulties. 
Effective practices begin with core instruction that 
is explicit and systematic, using evidence-based 
instructional strategies and techniques (Boulay et 
al., 2015) and include universal screening to identify 
students at risk for reading difficulties (Connor, 
Alberto, Compton, O’Connor & National Center 
for Special, Education Research, 2014). Identified 
students need access to targeted instruction outside 
of core curriculum with regular progress monitoring, 
typically administered in a small group setting (Tier 
2). If students still aren’t progressing, they may 
need additional support through one-to-one (Tier 3) 
interventions. Educators target specific reading skills 
and monitor the student’s response to the intervention. 
The resulting data should be used in the decision-
making process, including possible identification for 
services in exceptional education (Wanzek at al., 
2013).

Disfluent readers need targeted practices addressing 
oral reading fluency. With the correlation between 
fluency and reading proficiency, these questions 
remain: Are educators doing enough to assist disfluent 
readers in development of fluent oral reading? What 
other strategies could assist educators in meeting the 

needs of students who are struggling with fluent oral 
reading and are not benefiting from existing Tier 1 and 
Tier 2 interventions?

Neurological Impress Method  
(NIM): A Forgotten Intervention
Heckelman’s (1966) underutilized assisted reading 
strategy, the NIM, is a promising intervention for 
students struggling with disfluent reading. The NIM 
(Heckelman, 1966) has a research base going 
back decades; however, it is not widely practiced in 
classrooms because few educators are aware of the 
technique (Young et al., 2015). In this intervention, 
the teacher and student sit side-by-side reading a 
passage of text aloud together, in a form of assisted 
reading. The teacher reads slightly ahead, into the left 
ear of the student using texts that are approximately 
two levels above the student’s instructional reading 
level. The student reads aloud with the teacher and 
will mimic the teacher’s prosodic, fluent reading. 
Heckelman is not the creator of the NIM, but found 
that methods used in speech and language therapy 
to address stuttering could be applied to help with oral 
reading difficulties (Heckelman, 1966; Young et al., 
2015). In an early study, Heckelman (1969) reported 
an average gain in reading proficiency of two grade 
levels, for 24 disfluent readers receiving the NIM 
treatment over a period of six weeks.

Very few studies examining the NIM have been 
conducted over the past decade. Flood et al. (2005), 
tested the effectiveness of the NIM in their version 
of the intervention, titled the Neurological Impress 
Method Plus (NIM Plus), with researchers including 
a comprehension component. This study included 20 
participants reading below grade level in grades three-
six. Each student was paired with a student teacher, 
trained in NIM Plus, and was given this intervention 
over a period of five weeks. The intervention was 
delivered four days a week with each session lasting 10 
minutes. Researchers reported a significant increase 
in oral reading fluency and reading comprehension for 
all students (Flood et al., 2005). The NIM intervention 
was also implemented with two third-grade students 
struggling with oral reading fluency for a period of 
10 weeks, with researchers reporting over a year’s 
growth in reading proficiency (Mohr, Dixon, & Young, 
2012). Young et al. (2015) reintroduced this very 
promising intervention and called it, Reading Together, 
a combination of the NIM and repeated reading. In 
this quasi-experimental study, the sample included 
52 students in grades three-five, who had failed the 
state’s standardized assessment in the previous 
year. From this sample, 29 students were selected 
for treatment and compared against a control group, 
receiving instruction as usual. The treatment consisted 
of the one-to-one NIM intervention using volunteer 



GEORGIA JOURNAL OF READING 9 VOLUME 41, NUMBER 1   2018

tutors for 30 minutes a day for a period of one month. 
Researchers reported statistically significant increases 
in oral reading fluency and reading comprehension.

Addressing Potential Difficulties with 
Implementation of the NIM
Although research surfaced in 1980s regarding 
the NIM, it is a largely forgotten intervention in all 
educational circles. One possible reason is that the 
NIM requires a one-to-one ratio between teacher and 
student. It is also possible that educators simply aren’t 
aware of the benefits of this type of reading intervention 
although three common strategies are thought to 
have evolved from the NIM: assisted reading, listen-
while-reading, and paired reading (Anderson, 1981; 
Rasinski & Young, 2014).

Although NIM is relatively easy to learn and 
inexpensive since it does not require specific tools, 
technology, or additional instructional materials, still, 
one-to-one interventions can be difficult to implement. 
However, studies show people other than teachers 
can be trained to provide this intervention. Young et 
al. (2015), reported success using volunteer tutors to 
deliver this intervention. Flood et al. (2005), discussed 
the possibility of training proficient students as peer 
tutors. It may be possible, through the use of software 
or podcasts, to use technology to provide struggling 
students with this type of assisted reading strategy 
(Rasinski & Young, 2014).

NIM in Action
Recently, author one implemented NIM in a fifth-
grade classroom in an effort to explore the following 
question: What are the experiences of tutors and 
classroom teachers providing the NIM intervention in 
a fifth-grade classroom for a period of five weeks? The 
first author of this paper, a former elementary school 
teacher, now a doctoral student, consulted with a fifth-
grade teacher, referred to above by the pseudonym of 
Mrs. Smith. Mrs. Smith had concerns about students 
struggling with oral reading fluency. We studied the 
implementation of NIM using a qualitative approach 
that employed a phenomenological research design 
(Cresswell, 2009); our purpose was to explore the 
potential of NIM, as experienced through the lived 
experiences of the participating teacher and volunteer 
tutors.

For the purpose of this qualitative research study, 
students scoring below the district’s grade level 
benchmark in oral reading fluency rate were 
considered disfluent. Oral reading fluency rate was 
measured as WCPM and collected by the classroom 
teacher using curriculum-based assessments. The 
teacher selected six disfluent students, three female 
and three male, to receive the NIM intervention. All 

students were identified as performing below grade 
level through district created base-line assessments 
and were receiving tier two interventions, addressing 
primarily reading comprehension.

The author provided training on the NIM to three tutors 
who were currently tutoring in the teacher’s classroom. 
The tutors consisted of a former reading coach, a 
former teacher, and a retired business owner who 
was once enrolled in teacher education courses but 
did not finish the program. All tutors had experience 
volunteering in the teacher’s classroom for at least two 
years, mainly assisting in reading assessment and 
data collection. For example, tutors often assessed 
and recorded weekly oral reading fluency rates. One 
tutor also worked with a small group of students in a 
weekly book club. The training included a description of 
the NIM, the purpose of the intervention, explanations, 
and intervention demonstration using the step-by-step 
guidelines provided in Table 1. Each tutor took turns 
demonstrating the intervention during the training and 
received feedback from the first author.

For a period of five weeks, the tutors implemented 
the NIM during the core reading block; they used 
leveled readers, approximately two levels above the 
students’ instructional level. The leveled readers were 
selected by the first author using instructional reading 
levels provided by the teacher. Tutors worked one-
on-one with the students using the NIM, with each 
session lasting about fifteen minutes. The sessions 
took place at a teacher table positioned in the side of 
the classroom while the teacher continued with whole 
group instruction.

During the five weeks of the NIM intervention, the first 
author met with two of the tutors and the classroom 
teacher on two occasions. They were asked to share 
overall impressions of the experience through an 
informal interview with the first author. They were 
also asked to share any concerns. The meetings took 
place in the classroom while students were out of the 
room. The tutors and the classroom teacher reported 
that the intervention was easy to learn and implement 
within the classroom without interrupting regular 
instruction. In the beginning of the five-week period, 
each tutor came in one day a week and worked with 
each of the six students, providing the intervention for 
about fifteen minutes per student. After about three 
weeks, the six students worked with only two of the 
tutors. The first author observed two of the tutors 
and provided feedback as needed using the step-by-
step guidelines in Table 1. In addition, the first author 
attempted to observe the third tutor, however the tutor 
was not available due to illness.

The tutors reported some organizational challenges. 



GEORGIA JOURNAL OF READING 10 VOLUME 41, NUMBER 1   2018

Since each student worked with different tutors, the 
tutors did not always know where to start in the text 
at the beginning of each session. The first author and 
classroom teacher created a chart that allowed tutors 
to record the students’ placement in the text at the end 
of each session. There was still some confusion, but 
the tutors found that students generally remembered 
where to begin at each session. This specific challenge 
could be minimized by assigning each student to a 
specific tutor. The other challenge reported occurred 
around the holidays, with tutors unable to come in 
consistently and other changes in class schedule.

The classroom teacher reported that according to 
curriculum-based weekly fluency assessments, 
students improved in oral reading fluency rate 
measured as WCPM. The teacher and tutors reported 
an observable improvement in prosody, with students 
mimicking the tutors’ phrasing and expression during 
the intervention. The most notable change was the 
improvement in the students’ self-confidence in their 
oral reading ability during the intervention, possibly 
resulting from reduction in anxiety related to oral 
reading. In the beginning, some tutors stated that 
several students were reluctant to read aloud and 
appeared very anxious. At the end of the five weeks, 
the classroom teacher reported that students were 
visibly less anxious when reading aloud. The tutors 
and the teacher stated that students found it easier to 
read aloud after participating in the intervention.

Limitations to this exploratory study include a lack of 
systematic data collection, self-reports, small sample 
size, and duration of intervention. Although there are 
several methodological limitations associated with this 
study on NIM in action, this example of the NIM use 
highlights how easy it is to implement in a classroom 
setting, as well as the potential of NIM for supporting 
the development of students’ oral reading fluency.

Table 1
Step by Step Protocol for Implementation: 
Neurological Impress Method (adapted from Flood 
et al., 2005; Young et al., 2015; Young et al., 2016)

1The teacher selects a text approximately two 
levels above the student’s instructional level. If 
the text seems too easy or too challenging, the 

teacher may adjust the reading level of the text.

2   The teacher and student sit side by side to enable 
the teacher to read the text into the student’s left 
ear.

3  Both the teacher and student track print as they 
read, either from identical copies of the same 
text or  from one copy of the text. If reading from 

the same copy, the student’s finger should be placed 
on the teacher’s finger as they track print.

4 Both the teacher and student should move their 
finger as they read to ensure tracking of print.

5 The teacher reads slightly ahead of the student. 
The teacher will need to adjust his or her pace 
to match the student’s pace throughout each 

reading.

6 The teacher models fluent reading, using 
expressive phrasing, chunking of text, and 
stopping at punctuation, while the student reads 

along.

7 The student, independently, rereads the text 
aloud once, in a repeated reading format.

8 At the end of each session, the student retells or 
summarizes the reading to the teacher.

Conclusion
Teachers need access to high impact instruction in 
foundational literacy or struggling students may find it 
difficult to comprehend texts at a critical level. When 
students begin to struggle with foundational reading 
skills, educators need to find the best interventions 
to support struggling readers. When a child does 
not master content, it is ineffective to repeat the 
same practices in an effort to provide an intervention 
(Anderson, 1981). Students struggling with disfluent 
oral reading, who have not made sufficient progress 
through small group targeted instruction, could benefit 
from the one-to-one oral fluency intervention, the NIM. 

Fluency deserves more attention. Students are 
struggling and as the 2015 NAEP results showed, the 
majority of 4th and 8th grade students are not reading 
at a proficient level. Students struggling to achieve 
fluent oral reading may be at risk for poor reading 
comprehension, (NRP, 2000; Valencia & Buly, 2004) 
as fluency is a contributing factor in poor reading 
achievement. Fluency isn’t all that is needed to create 
good reading comprehension, but it is an essential 
piece of the puzzle (Rasinski, 2016).

Non-proficient readers need effective interventions to 
support the level of improvement needed to master 
CCSS (Shanahan, 2012; Rasinski, 2016). Educators 
are urged to examine current practices to ensure 
students are receiving evidence-based, targeted 
instruction. Our situated implementation of the 
NIM provided us with positive results, although our 



GEORGIA JOURNAL OF READING 11 VOLUME 41, NUMBER 1   2018

implementation had several methodological limitations 
that prevent us from making any generalizations to 
other contexts. At the same time, we are excited about 
the NIM method. Existing research on the NIM has 
also shown the potential of the method for developing 
students’ prosody (Rasinski & Young, 2014). Although 
the NIM is not a quick fix for all students’ reading fluency 
challenges, it is a promising method for facilitating 
fluency development with struggling readers. While 
struggling readers should still receive comprehensive 
interventions, the NIM has the potential to provide 
additional support to students struggling with disfluent 
reading. The NIM is extremely easy to learn, does not 
require specific equipment or materials, and can be 
implemented by classroom and exceptional education 
teachers, reading interventionists, paraprofessionals, 
volunteer tutors, as well as parents who can be easily 
trained in this method (Anderson, 1981; Rasinski & 
Young, 2014; Young et al., 2016).

In the last decade, there have been very few studies 
exploring the effect of the NIM on students’ oral 
reading fluency and reading comprehension. There 
is a need for more current research to determine the 
impact of this intervention on disfluent readers. Several 
questions remain regarding the NIM as a one-to-one 
reading fluency intervention. For example, could the 
NIM effectively increase students’ oral reading fluency 
if implemented in a small group of three students as 
opposed to the one-to-one format? This could create a 
greater impact as many students face similar reading 
struggles similar to those described in the case of 
Sophia. Also, given the recent attention to critical 
literacy and close reading, could a more effective 
approach to the use of NIM include a comprehension 
component such as Flood et al., (2005) describe in 
the intervention, the NIM Plus? Further research is 
needed on the role of the NIM in facilitating students’ 
reading fluency. In our view, existing research on the 
NIM provides some evidence for giving it another 
chance for one-on-one reading fluency interventions.

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Georgia Reading Association (GRA). Do not send cash. 
Send form to: Loretta Vail, 335 Cypress Lane, Stockbridge, Georgia 30281

q New Membership    q Renew   GRA Number ______________ Date ______________
Name ____________________________________________________________________
E-mail ___________________________________________________________________
City, State, Zip  ____________________________________________________________
Circle one (if applicable):   Retiree Member    Student Member
Are you an IRA member?   q Yes   q No    IRA Number ___________________________
Home Phone _________________________ Work Phone __________________________


