Reading games for struggling readers: what actually works

Last updated 2026-07-11

Why do reading games work for struggling readers?

Games work because they lower the stakes. A child who has failed at reading dozens of times in front of peers and teachers will often try harder when the activity feels like play. That's not a fluffy theory. A 2019 meta-analysis in the journal Reading and Writing examined 49 studies of game-based learning in literacy and found a moderate positive effect size (g = 0.49) on word reading outcomes, with the strongest gains in phonological awareness and decoding ^[1].

The mechanism is simple. Games create repeated practice without the emotional cost of a worksheet. A child who would quit a phonics drill after three minutes will happily play a word-building card game for fifteen. Repetition is exactly what struggling readers need. The National Reading Panel's 2000 report found that explicit, repeated practice in phonemic awareness, phonics, fluency, and vocabulary all produce measurable reading gains ^[2].

There's a catch, though. Not every game marketed as a "reading game" targets the skills struggling readers actually need. Many popular apps reward clicking speed or guessing from picture context, which is the opposite of what a child with a phonics gap needs. The games that help are built around the science of reading: systematic phonics, phonological awareness, and repeated oral reading. The ones that don't mostly ask kids to read whole words by sight and guess the rest.

So the first question before you buy or download anything is this: what skill does my child actually need to practice? A child stuck on blending consonant clusters needs something different from a child who can decode but reads so slowly that comprehension falls apart. Keep that distinction in mind through everything that follows.

What skills should reading games target for a child who is behind?

Reading science has a clear answer. Skilled reading depends on a specific set of foundational skills, and struggling readers are almost always weak in one or more of them. The Simple View of Reading, first proposed by Gough and Tunmer in 1986 and replicated many times since, says reading comprehension equals decoding ability multiplied by language comprehension ^[3]. If either component is weak, the whole product suffers.

For most struggling readers, the bottleneck is decoding, not comprehension. So the game you choose should usually target one or more of these skills:

• Phonemic awareness: hearing and manipulating individual sounds in spoken words
• Phonics and decoding: matching letters and letter patterns to sounds
• Fluency: reading connected text smoothly and accurately enough that comprehension can happen
• Vocabulary: knowing what the words mean once decoded
• Comprehension: building meaning from text

The table below maps skill areas to the game types that address them most directly.

Skill	What it means	Game types that help
Phonemic awareness	Hearing that "cat" has 3 sounds	Rhyme games, sound-sorting card games, oral blending games
Phonics / decoding	Knowing that "ch" says /ch/	Word-building tiles, decodable-word card games, letter-pattern bingo
Fluency	Reading accurately and at a natural pace	Repeated reading games, partner reading races, reader's theater
Vocabulary	Understanding word meanings	Word sorts, definition guessing games, context clue games
Comprehension	Making meaning from text	Story-retell games, question-answer games, prediction challenges

A child with dyslexia will almost always need games in the phonemic awareness and phonics columns first. A child who decodes fine but reads slowly needs fluency games. If you're not sure which category fits your child, a simple informal reading inventory or a conversation with their teacher or reading tutor can point you in the right direction.

Which card and board games are best for phonics and phonemic awareness?

Card and board games are my first recommendation for most families. No screen, no subscription, no tech support. They also create real human interaction, which matters for kids who've been isolated by reading struggles.

Here are the options I'd actually put in front of a struggling reader, organized by skill:

Phonemic awareness (ages 4-7)

Zingo Sight Words (ThinkFun) gets kids matching tiles to cards, but for true phonemic awareness a simple rhyme-sorting card game beats it. You can make one with index cards: write a word on each, then ask the child to sort by ending sound. Free and effective.

Oral blending games, where an adult says the sounds and the child guesses the word, work well for kids who haven't yet grasped that spoken words are made of separable sounds. No purchase needed.

Phonics and decoding (ages 5-10)

Blink (Mattel) is fast matching and builds visual processing speed, but it's not phonics-specific. For actual phonics, word-builder card games (sold by several educational publishers for roughly $10 to $15) ask players to combine onset and rime cards to make real words. These come close to what an Orton-Gillingham tutor would use in a lesson.

Bob Books Puzzle Words (Scholastic) and Explode the Code board adaptations target short-vowel CVC words, which is exactly where many struggling early readers get stuck.

Pattern-based bingo games (like those from Learning Resources) work well for letter-pattern recognition once a child can handle individual sound-letter pairs.

A word of caution on cost. Some "educational" games sell for $30 to $50 and don't deliver anything a $3 deck of index cards can't. I wouldn't spend more than $15 to $20 on any single game until you've confirmed your child will engage with it. Borrow from the library first when you can.

What are the best reading games for fluency practice at home?

Fluency is the most underrated skill in the home-practice toolkit. Parents hear that their child can decode words and assume the reading problem is solved. But a child who reads 40 words per minute in 2nd grade, when typical readers manage 89 ^[4], can't hold a sentence in working memory long enough to understand it.

The good news: fluency games are some of the easiest to run at home with no materials at all.

Repeated reading races. Pick a short passage at the child's independent reading level (they can decode at least 95% of words without help). Time the first read. Then do it again. And again. The goal isn't speed for its own sake. It's watching their own improvement. A kid who sees their time drop from 90 seconds to 65 across four reads feels something they haven't felt in reading before: progress. That feeling is hard to manufacture any other way.

Reader's Theater. These scripts are meant to be performed, not memorized. Kids read their lines aloud, repeatedly, to prepare for a "performance" for a parent or sibling. The research base is solid. A 2000 study by Rasinski found that repeated reading in performance contexts produces significant fluency gains ^[5]. Free Reader's Theater scripts show up at many school library sites and through ReadWorks (readworks.org).

The Fluency Phone. This one costs about $3 in PVC pipe from a hardware store. Bend two 45-degree elbows into a phone shape. The child reads into one end and hears their own voice amplified in the other. It's surprisingly motivating for kids who hate hearing themselves read aloud. The feedback loop helps self-monitoring.

For children working toward specific reading goals for struggling readers, graphing words per minute weekly gives them a picture of growth. That data also becomes useful evidence if you're working with a school on an IEP or 504 plan.

For more structured fluency work, see reading fluency strategies that actually work for struggling readers.

Are reading apps and digital games actually effective, or mostly hype?

Honest answer: it depends entirely on the app. Some digital reading programs have solid evidence behind them. Most don't.

The apps with the best evidence base are built explicitly on structured literacy: sequential phonics instruction, phonemic awareness training, and decodable text. Here's how the main categories break down.

Apps with real research support:

Rocket Phonics and Phonics Hero are built on synthetic phonics sequences and have independent evaluations supporting their use for early readers. GraphoGame, developed by researchers in Finland and adapted for English, has randomized controlled trial evidence showing gains in phonemic awareness for at-risk readers ^[6].

Sylvan Learning's app-based programs and IXL's reading module have wider commercial use but mixed independent evidence. They're fine supplements, not substitutes for explicit instruction.

Apps that sound good but lack evidence:

Many "adaptive" reading apps claim to personalize instruction but really just adjust text difficulty without changing the type of instruction. A child with a phonics gap needs explicit phonics, not harder sight-word passages.

Epic! and similar digital libraries help with reading volume and motivation, but they don't teach decoding. Don't confuse access to books with reading instruction.

The screen-time question. The American Academy of Pediatrics recommends limiting recreational screen time for children 6 and older and draws a line between passive and interactive educational use ^[7]. A 15-minute phonics app session that produces focused practice is a different thing from an hour of general browsing. Intent is the difference.

My honest take: for children with identified reading disabilities, I'd spend 80% of practice time on structured, human-led activities and 20% on digital games as a motivational supplement. Apps don't replace a skilled tutor or a properly run IEP. If your child needs more targeted support, a reading comprehension tutor or online reading tutoring may deliver more per hour than any app.

What free reading games can I use without spending any money?

A lot. This is one area where parents get routinely oversold. Here's a practical list of free options that actually work.

Free digital tools:

ReadWorks (readworks.org) offers free reading passages with comprehension questions, organized by grade and Lexile level. It's not a game exactly, but you can turn it into one (set a timer, let kids earn a sticker for each passage) at no cost.

Starfall (starfall.com) has a free tier with phonics activities and decodable books for K-2 readers. The paid tier runs about $35 a year, but the free version is substantial.

Khan Academy Kids (free on iOS and Android) includes reading and phonics games built on evidence-based sequences. No ads, no in-app purchases.

Let's Go Learn (letsgolearn.com) offers reading assessments that can help you pin down which skill to target before you pick a game.

Free low-tech games you make yourself:

Sound boxes: draw a row of three boxes on paper, say a word, ask the child to push a penny into each box as they say each sound. This is the classic Elkonin boxes technique, and it costs zero dollars ^[11].

Word ladders: write a word, change one letter at a time to make a new word (cat, bat, bad, bid). Lewis Carroll invented word ladders in 1877. They're still one of the best phonics practice tools around.

Rhyme time card flip: write words on index cards, mix them, flip two at a time, decide if they rhyme. Good for phonemic awareness with pre-readers.

For printable materials that extend practice, printable reading comprehension sheets by grade level are widely available and pair with any of the games above.

How do reading games fit into an IEP or 504 plan?

This is where things get practical for families dealing with school systems. Under the Individuals with Disabilities Education Act (IDEA), children identified with a reading disability are entitled to specially designed instruction that addresses their specific needs ^[8]. Games, on their own, don't meet that bar. But they can be a legitimate part of a multi-component intervention when used with intent.

Here's what the law says parents can reasonably expect and push for.

IDEA requires that a child's IEP include measurable annual goals and describe the services the school will provide to help the child reach them ^[8]. If your child's reading goals include phonemic awareness or fluency benchmarks, you can ask the IEP team to specify which evidence-based interventions they'll use to hit those goals.

The Every Student Succeeds Act (ESSA) also requires schools to use evidence-based interventions, defined as practices supported by "strong," "moderate," or "promising" evidence ^[9]. You can ask the school to name the evidence tier of any program they're using.

"The term 'specially designed instruction' means adapting, as appropriate to the needs of an eligible child... the content, methodology, or delivery of instruction," reads the definition in 34 CFR § 300.39 ^[8]. That language gives parents real footing to push back when the school's only response to a struggling reader is more of the same whole-class instruction.

Games used at home as practice support an IEP. They don't replace it. If you're playing structured literacy games at home that match what the school teaches (same phonics sequence, same vocabulary), that coordination helps. The ReadFlare parent advocacy kit includes an IEP goal-tracking sheet families can use to connect home practice to school-based progress monitoring.

If the school isn't responding well enough, see the parent resources on school advocacy and consider requesting an independent educational evaluation at the district's expense, which is a right under IDEA.

What reading games work best for kids with dyslexia specifically?

Dyslexia affects roughly 15 to 20% of the population and is marked by difficulty with accurate and fluent word recognition, poor spelling, and poor decoding, arising from a phonological processing deficit ^[10]. That phonological core is the key. Games that target phonological skills are the ones that matter most here.

The most effective games for children with dyslexia share a few features. They're multisensory (hearing, seeing, and touch), they follow a systematic phonics sequence, and they allow mastery at each level before moving on. That's essentially the Orton-Gillingham approach in game form.

Specific recommendations:

Tapping syllables: the child taps the table or a rubber band to segment a word into syllables before spelling it. Simple, free, and aimed straight at dyslexia's syllable-awareness weakness.

Magnetic letters and tiles: rather than writing, children with dyslexia often find manipulating physical letters easier. Games where they build words by sliding tiles together cut the fine-motor load of writing while keeping the phonics practice.

Go Fish with phonics cards: swap the numbers for phoneme-grapheme pairs. A child asks for the card that matches the /sh/ sound, for example. Buy these or make them.

Fluency Phones (described in the fluency section above) also help kids with dyslexia because amplifying their own voice strengthens the auditory feedback loop their phonological system tends to underuse.

One thing to avoid: games built around whole-word memorization, like classic Sight Word Bingo where kids match the printed word without decoding it. Children with dyslexia need to be taught to decode, not to memorize shapes. Too many sight-word-only games can reinforce the guessing habits that block progress.

For deeper context on phonics and decoding instruction for children with dyslexia, see how to improve reading comprehension and the phonics-and-decoding hub on this site.

What are the best reading games by age and grade level?

The right game depends more on where the child is developmentally than on their birthday. A 9-year-old who reads like a beginning 1st grader needs beginning 1st-grade games, not 3rd-grade games with simpler rules. That said, here's a practical age-and-grade breakdown for parents who want a starting point.

Pre-K and Kindergarten (ages 4-6): Focus on phonemic awareness before phonics. Rhyming games, clapping syllables, and I Spy sound games ("I spy something that starts with /b/") fit here. Starfall's free tier matches this level well.

1st and 2nd grade (ages 6-8): Phonics becomes the main target. Word-building card games with short-vowel CVC words, onset-rime sorting, and simple decodable-text partner reading work well. For grade-level comprehension support, see 1st grade reading comprehension and 2nd grade reading comprehension.

3rd and 4th grade (ages 8-10): A child still struggling at this stage may have a phonics gap that slipped through earlier. Phonics games are still fair game. Don't jump to comprehension-only activities if decoding is weak. Fluency games matter more here, and Reader's Theater works well at this age. See 4th grade reading comprehension for passage-based practice.

5th and 6th grade (ages 10-12): Older struggling readers often find phonics-level games babyish, which is a real barrier. Frame games around strategy or challenge instead of skill-building. Vocabulary games (Bananagrams, word-root activities) feel more age-appropriate while still building reading skills. Fluency games with harder texts work. 6th grade reading comprehension passages with game-like scoring can help.

Middle school and above: Older students need games that don't look like games for little kids. Crossword puzzles, word-root card games, and vocabulary-in-context guessing games work. Repeated oral reading with a timer still builds fluency, but the student picks the text. Autonomy matters more at this age.

How do I set reading goals that actually connect to game practice?

Reading goals for struggling readers need to be specific, measurable, and matched to the child's current skill level. A vague goal like "read more" gives you no way to measure progress or adjust course.

A useful structure comes from the SMART framework that schools use in IEPs: Specific, Measurable, Attainable, Relevant, Time-bound. Here's what that looks like in practice.

Vague: "My child will get better at reading." Useful: "By December 1, my child will read a 2nd-grade decodable passage at 80 words per minute with at least 95% accuracy, up from the current 55 words per minute."

The 95% accuracy standard comes from reading research. Below 90% accuracy usually means the text is frustration level (too hard for productive practice), 90 to 94% is instructional level, and 95% and above is independent level ^[4]. Games should be played at independent or instructional level, never frustration level. A child who misses more than one word in ten is spending cognitive energy on decoding and has none left for learning.

Tracking progress weekly, even loosely, tells you whether a game is working. If a child has played the same phonics card game for three weeks and their accuracy on the target pattern hasn't budged, the game isn't working for them. Try a different approach.

The ReadFlare free reading tools section includes a simple progress-tracking sheet families can use to log words per minute and accuracy over time. That data also helps when you're talking to teachers or requesting an IEP meeting.

For structured reading comprehension practice tied to measurable goals, passages with built-in comprehension checks are the easiest way to document growth.

What should I avoid when choosing reading games for a child who is behind?

Some games actively work against a struggling reader. Here's what to pass on.

Context-guessing games. Any game that rewards a child for guessing a word from the picture or the first letter trains a habit reading researchers call the "word guessing strategy." Children who read by guessing aren't reading. They're predicting. This falls apart the moment they hit multi-syllable words with no picture. Avoid any game where the correct move is to look at the picture and guess.

Timed games that create anxiety. Some children with reading disabilities already tie reading to failure and shame. A game that penalizes them for being slow reinforces that link. Timed games work when the child times themselves against their own past performance. They fail when the child competes against peers who read easily.

Games pitched too high. A 3rd grader reading at a Kindergarten level playing a 3rd-grade vocabulary game will fail at almost every turn. That's not practice. It's repeated failure in game form. Match the game to the reading level, not the grade level.

"Learning" apps that are mostly entertainment. An app where the child taps colorful objects and occasionally meets a letter is mostly entertainment. Nothing wrong with entertainment, but it shouldn't count as reading practice. If the app has no clear phonics or comprehension sequence, it's probably not touching your child's specific gap.

Games that skip phonics for older kids. There's a real temptation to stop phonics work with an older struggling reader because it feels age-inappropriate. But a 10-year-old with a phonics gap needs phonics instruction. The fix is to find phonics games designed for older learners, not to skip phonics and hope comprehension strategies compensate.

How much time should kids spend on reading games each week?

Short and frequent beats long and occasional. Every time. This is one of the most consistent findings in reading intervention research ^[2].

For struggling readers, 15 minutes of focused daily practice produces better results than a 90-minute session once a week. The brain needs distributed practice to build automaticity in decoding. Think of it like learning an instrument. Daily short sessions build fluency faster than weekend marathons.

A realistic weekly schedule for home practice might look like this:

• Monday through Friday: 10 to 15 minutes of a targeted phonics or fluency game
• Two or three of those sessions: add 5 to 10 minutes of reading aloud from a decodable book
• Weekend: a longer, lower-stakes activity like Reader's Theater or a word game that feels recreational

Total: roughly 60 to 90 minutes of structured practice per week, spread across the week.

Still, fatigue and frustration are real. If a child hits a wall at 10 minutes, stop at 10 minutes and count it as a win. Ending on a positive note matters for a child who already associates reading with failure. Progress over perfection, every time.

For families who want to extend practice through passages and comprehension activities, reading comprehension worksheets and reading comprehension passages add variety without adding cost.

Frequently asked questions

What are the best reading games for a 7-year-old who struggles with phonics?

For a 7-year-old with phonics gaps, focus on word-building card games using short-vowel CVC patterns (cat, sit, hop) and onset-rime games. Magnetic letter tiles work well because they're tactile. Starfall's free tier and Khan Academy Kids both have structured phonics sequences for this age. Aim for 10 to 15 minute sessions daily rather than longer weekly ones.

Can reading games really replace formal reading intervention?

No. Games are practice tools, not instruction. A child with a significant reading disability needs explicit, systematic instruction from a trained teacher or tutor, ideally using a structured literacy approach. Games can extend practice time and cut anxiety, but they don't deliver the calibrated feedback and sequential instruction that intervention does. Think of games as the reps between coaching sessions, not the coaching itself.

Are there free reading games I can use with my child right now?

Yes. Khan Academy Kids is free with no ads. Starfall.com has a substantial free tier for K-2 phonics. ReadWorks.org offers free passages and comprehension questions. For zero-cost offline options, Elkonin sound boxes (pennies and drawn boxes), word ladders (changing one letter at a time), and rhyme-sorting with index cards cost nothing and are backed by solid reading research.

What is the best reading game for a child with dyslexia?

Multisensory word-building games that use tiles, magnets, or tapping are most effective for dyslexia because they engage several senses at once, which matches Orton-Gillingham principles. Syllable-tapping games and phoneme-grapheme matching card games (Go Fish style) hit the phonological core of dyslexia directly. Avoid whole-word memorization games. Pair games with a structured phonics sequence your child is already learning.

How do I know if a reading game is actually at my child's level?

Have your child read a short passage from the game's target text level. If they miss more than 1 word in 10 (below 90% accuracy), the game is too hard for productive practice. For phonics games, give them 5 to 10 of the targeted word patterns and see how many they read correctly. Aim for 90 to 95% success so the child builds on what they know instead of drowning in errors.

Can I ask the school to use reading games as part of my child's IEP?

You can request that specific evidence-based interventions go into the IEP, and games that are part of a validated program (like those in Orton-Gillingham or Wilson Reading curricula) qualify. Under IDEA, IEP services must be based on peer-reviewed research to the extent practicable. Ask the school to identify the evidence tier of any program they use, as required by the Every Student Succeeds Act.

What reading games work for older struggling readers in middle school?

Older readers often reject games that look childish, so framing matters. Crossword puzzles, word-root card games, vocabulary-in-context challenges, and timed self-improvement reading activities feel more age-appropriate. Reader's Theater with the student choosing the script works well at this age. The key is preserving autonomy: let the student choose among options rather than assigning a game like a worksheet.

How long should reading game sessions be for a struggling reader?

10 to 15 minutes per session, five days a week, beats one or two long sessions. Daily distributed practice builds automaticity faster than massed practice. If a child hits frustration before 10 minutes, stop early and end on a small success. Research consistently shows that shorter, frequent practice intervals outperform longer, rarer ones for struggling readers.

Do reading games help with reading comprehension or just decoding?

It depends on the game. Most reading games with strong evidence target decoding and fluency, not comprehension directly. Comprehension games (story retell, prediction challenges, question-answer games) can help once decoding is stable. For children whose decoding is fine but comprehension lags, vocabulary games and structured discussion beat phonics-focused games. See reading comprehension practice resources for passage-based options.

What is the 95% accuracy rule in reading practice?

Reading researchers define three levels by accuracy: independent (95%+ of words read correctly), instructional (90 to 94%), and frustration (below 90%). Games and independent practice should happen at independent or instructional level. Below 90% accuracy, a child spends most effort decoding individual words and little on learning. Most reading experts target instructional-level text for guided practice and independent-level text for fluency games.

Are sight word games helpful or harmful for struggling readers?

It depends. Sight word practice for the small set of truly irregular words (like 'the,' 'said,' 'of') is useful. Problems start when sight word games replace phonics instruction, training children to memorize whole-word shapes instead of decode. For struggling readers, especially those with dyslexia, phonics-first games should be the majority of practice time. Sight word memorization alone won't close a decoding gap.

How do I track whether a reading game is actually helping my child?

Track two things: accuracy (what percentage of target words the child reads correctly) and fluency (words read correctly per minute on a grade-level passage). Record both weekly on a simple chart. If neither improves after three to four weeks of consistent daily practice, the game isn't addressing the right skill or isn't at the right level. Adjust the game or consult a reading specialist.

What's the difference between a reading game and a reading intervention program?

An intervention program is a structured, sequential curriculum delivered by a trained educator with progress monitoring built in. Programs like Wilson Reading, SPIRE, or RAVE-O have specific evidence bases and require professional training to deliver correctly. Reading games are practice tools that reinforce skills taught in an intervention but can't replace its explicit, sequenced instruction. Games without instruction are like batting practice without a pitching coach.

Sources

1. Reading and Writing journal, Springer (Tokac, Novak & Thompson, 2019) - meta-analysis of game-based learning in literacy: A meta-analysis of 49 studies found a moderate positive effect size (g = 0.49) on word reading outcomes from game-based literacy learning, with strongest gains in phonological awareness and decoding
2. National Institute of Child Health and Human Development, Report of the National Reading Panel (2000): Explicit, repeated practice in phonemic awareness, phonics, fluency, and vocabulary all produce measurable reading gains; distributed practice in phonemic awareness is more effective than massed practice
3. Gough, P.B. & Tunmer, W.E. (1986). Decoding, reading, and reading disability. Remedial and Special Education, 7(1), 6-10: The Simple View of Reading states that reading comprehension equals decoding ability multiplied by language comprehension
4. Hasbrouck, J. & Tindal, G. (2017). Oral Reading Fluency norms, University of Oregon Behavioral Research and Teaching: Typical 2nd graders read about 89 correct words per minute at mid-year (50th percentile); accuracy levels are defined as independent (95%+), instructional (90-94%), and frustration (below 90%)
5. Rasinski, T.V. (2000). Speed does matter in reading. The Reading Teacher, 54(2), 146-151: Repeated reading in performance contexts such as Reader's Theater produces significant fluency gains for struggling readers
6. Lyytinen, H. et al. (2009). GraphoGame: A technological solution to the problem of inadequate literacy in the world's languages. University of Jyväskylä: GraphoGame has randomized controlled trial evidence showing gains in phonemic awareness for at-risk readers
7. American Academy of Pediatrics, Media and Children Communication Toolkit: The American Academy of Pediatrics recommends limiting recreational screen time for children 6 and older and distinguishes between passive and interactive educational use
8. Individuals with Disabilities Education Act, 34 CFR § 300.39 - Specially Designed Instruction definition; IDEA Part B: IDEA defines specially designed instruction as adapting content, methodology, or delivery of instruction to meet an eligible child's needs; IEPs must include measurable annual goals and describe services provided
9. Every Student Succeeds Act (ESSA), U.S. Department of Education - Evidence standards for interventions: ESSA requires schools to use evidence-based interventions defined by strong, moderate, or promising evidence tiers
10. International Dyslexia Association, Definition of Dyslexia (adopted by NICHD): Dyslexia affects approximately 15-20% of the population and is characterized by difficulty with accurate and fluent word recognition arising from a phonological processing deficit
11. Reading Rockets (WETA, U.S. Dept of Education funded) - Elkonin boxes technique: Elkonin sound boxes (pushing tokens into boxes for each phoneme) are a research-supported technique for phonemic awareness instruction
12. U.S. Department of Education, Office of Special Education Programs (OSEP) - IEP requirements under IDEA: IEPs must include measurable annual goals and describe specially designed instruction; parents may request specific evidence-based interventions be specified