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Assessing and Differentiating Reading Disorders . Linda J. Lombardino, Ph.D. Professor of Speech-Language Pathology School of Special Education, School Psychology and Early Childhood Studies llombard@ufl.edu Presentation at The Ohio State University Department of Speech and Hearing Science
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Assessing and Differentiating Reading Disorders Linda J. Lombardino, Ph.D. Professor of Speech-Language Pathology School of Special Education, School Psychology and Early Childhood Studies llombard@ufl.edu Presentation at The Ohio State University Department of Speech and Hearing Science January 26, 2012
Aims of Assessing and Differentiating Reading & Writing Disorders: Multidimensional Model • Overview of component skills needed for skilled reading • Developmental Schemes for core components • Identify core weaknesses that underlie the struggling readers’ difficulties • Show sample tests for core areas • Provide diagnostic profiles with scientific support • Recommend specific treatments for case studies • Provide information on counseling parents
READING ACHIEVEMENT Language Knowledge Word retrieval Discourse Syntax Morphological Knowledge Vocabulary Text level reading Text level writing Word level spelling Word level reading Grapho-phonemic Integration “Alphabet principle” Phonological Knowledge Print Knowledge Environmental Factors Neurological Factors Multidimensional Model for Assessing Reading and Writing (MARwR)
Table 2-1. Ehri’s three-phase model of word-level reading • Phase I: Pre-Alphabetic Stage of Word Reading • Preschool (aka visual cue stage) • Key characteristic/strategy: • Learners recognize words by connecting salient visual cues within or around the word with words’ pronunciations or meanings (aka visual cue reading) • Primary Indicators: • Recognizes a word only when it occurs in a specific context • Does not recognize when letters in a word are replaced or letters are re-arranged (e.g., Pepsi spelled as Zepsi) • Unable to identify letters in own the printed name even if name is recognized • Examples: • Relies on contextual cues such as familiar logos (e.g., McDonald’s golden arches) to recognize a McDonald’s sign • Relies on the shape and color of a stop sign to recognize the word “STOP” • Relies on a meaningful pattern such as the two eyes in the word “bee” or the circle at the end of Pogo’s name to recognize these words in print • “Because the visual cues forming connections are not unique to individual words, children mistake visually similar words for one another (Ehri, 1992, p. 125).
Stages of reading acquisition cont. • Transition from Pre-Alphabetic to Partial Alphabetic Stage • Learners begin to use knowledge of a few letter names to form connections between letters and corresponding sounds at the beginning or end of words ( e.g, child uses the letter “l” to represent the sounds in “ball” when attempting to spell it). • Phase 2: Partial Alphabetic Stage of Word Reading • Kindergarten (aka phonetic cue stage) • Key characteristic: • Learners recognize words by connecting letters with sounds • Primary Indicators: • Knows the names of most letters in the alphabet • Shows the ability to segment the initial sound in a word from the remainder of the word • Uses knowledge of letter names and ability to partially segment words (phonemic awareness) to make systematic connections between letters and their corresponding sounds, especially at the beginning and ends of words. Knowing letter names gives access to phonetic cues that can be used to attempt word reading • Examples: • Spelling flower as “FLR” by using letter names to guide spelling • Misreading simple words such as “ for” for “from” and “like” for “lake ” while indicating that that s/he is using phonetic cues as a strategy for reading. • “It is important to note that sight word reading during the partial alphabetic phase is an imperfect process that occurs among be)ginners who lack full knowledge of the alphabetic system and phonemic segmentation skill (Ehri, 2005, p. 145).
Figure 2-11(developmental scheme of reading skills for readingachievement)
Brittany Profile 1 Severe spoken language & emergent literacy deficit
Gail (9 years)Profile 4 Mixed language and literacy deficits
In-take Forms • Appendix 3-1. Caregiver/teacher questionnaire for preschool-early first grade children • Appendix 3-2. Caregiver/teacher questionnaire for school age children at the end of 1st grade and beyond
Part 5Discussing & Interpreting Diagnostic ReportsGroup Activity Interpretations Recommendations
Sample #1 Student: 6 year, 4 month old female • At risk for language and literacy deficit • RECOMMENDATIONS • JJ should begin therapy focusing on: • Reading for recognition and decoding • Reading in words and sentences • Spelling in words and sentences • Listening comprehension using small graded paragraphs and then discussing the content • Accurate copying of numbers and words from a close distance and then further away • Math skills including addition and subtraction of single digits • It is recommended that JJ be examined to rule out Attention Deficit Disorder (ADD) • Recommended testing location: • Sarkis Family Psychiatry
Sample #2 Student: 5 year ,7 month old male • exhibits characteristics that are consistent with a diagnosis of developmental dyslexia (ICD-10-CD Code 315.02. Recommendations: • Andy is a bright child who presents with developmental dyslexia. Therefore, intervention and academic accommodations are essential for Andy to perform at his full potential. Andy can be successful if he is provided with appropriate and adequate methods of reading instruction. • The severity of Andy’s dyslexia creates an impairment that significantly hinders several major life activities, including reading and writing, learning, and listening. To meet Andy’s educational needs as adequately as other children his age, Andy will need the following classroom accommodations as he advances through elementary school, which can be provided through a 504 plan. • Andy should be given more time on tests and other class work.Andy should not be required to copy notes from the board, an overhead, or a book. Instead, the teacher should provide Andy with a copy of her own notes/overheads
Sample 2 cont. • Andy should be allowed to type all written assignments. • Andy’s spelling tests should not be graded. Because children with dyslexia are not able to master spelling the traditional way, Andy will be taught by a tutor using a different method. Until Andy’s spelling reaches grade level, he should be allowed to take spelling tests with his class, but they should not be graded. • Andy should be given reduced homework assignments in all of his subjects. The amount of homework required should be based on the time it would take students without the disability to complete the assignment. The number of problems or length of an assignment should be reduced, with feedback from his parents, until Andy is spending no more than 1 ½ the amount of time on homework as a student without dyslexia would spend. • These same accommodations should be provided on all standardized tests. • Andy should be enrolled in a multi-sensory phonics and fluency-based instructional program. Examples of such programs are: a) Barton Reading and Spelling System andb) Lindamood Phoneme Sequencing (LiPS)®. The features of these approaches are listed below.
Sample 2 cont Recommendations: The Barton Reading and Spelling System® is a tutoring program, which parents, volunteer tutors, resource specialists, and professional tutors can use with children, teenagers, and adults who have learning difficulty. It is an adapted and simplified version of the Orton-Gillingham approach to teaching reading and spelling. It includes fully scripted lesson plans, plus all reading material, spelling lists, homework pages, and training videos. The Lindamood Phoneme Sequencing (LiPS)® program is a multi-sensory, multifaceted program of phonemic awareness training of reading and spelling, based on a phonological foundation and rooted in the motor-articulatory feedback theory. This program facilitates perception of contrasts between speech sounds and the order of sounds in syllables in words, a critical skill needed for reading and spelling. A distinctive feature of the program is that the student is taught to self-correct rather than be given the right answers. If this program is chosen, Andy should attend therapy sessions implementing this program a minimum of three times per week. Components of the LiPS program are listed below: • Identifying and classifying speech sounds (consonants and vowels) • Tracking speech sounds (isolated sounds and sounds in syllables) • Associating sounds and syllables • Applying this sound-symbol knowledge to spelling (encoding) and reading (decoding)
Sample #3 Student: 9-year-old 1-month female (home schooled) • profile of strengths and weaknesses consistent with a diagnosis of Developmental Dyslexia (ICD-9 Code 315.02). Recommendations • The instruction must start with phonemic awareness instruction, followed by a systematic approach to phonics, both analytic and synthetic. • It must also teach reading and spelling as related subjects with intense practice and constant weaving of the concepts taught. • Orton-Gillingham-based systems such as the Barton Reading and Spelling Program,Wilson Reading System, and the Slingerland Approach meet these requirements.
Sample 3 cont. Recommendations continued • Enroll Rose in a more traditional school setting, however, it is imperative that school personnel be made aware of Rose’s need for educational support. • Enroll in Tier III reading instruction • At this level of intervention the reading instruction at school is intensive (i.e., 1:1 – 1:3 ratio), systematic, and provided for ninety (90) minutes per day in addition to her regular classroom reading instruction. (For more information on the Tier Model, the reader is referred to www.fcrr.org)
Sample 3 cont. Accommodations • The severity of R’s reading disability creates an impairment that substantially limits several major life activities, including reading, writing, learning, and listening. To meet her educational needs as adequately as a child without these disabilities, Rose will require classroom accommodations, which can be stipulated on a 504 Plan or an IEP.
Sample #4 Student: 10-year-old male • E’s scores from the present evaluation, along with parent observations, educational difficulties, and family history are consistent with a diagnosis of developmental dyslexia (ICD-10-CD Code 315.02) Recommendations • E be enrolled in a multi-sensory phonics- and fluency-based instructional program, which provides intense one-on-one intervention
Sample 4 cont Some examples are: • The Orton-Gillingham Method • Barton Reading and Spelling Program • The Wilson Reading System • Specialized Program Individualizng Reading Excllence (S.P.I.R.E) • The Slingerland Multisensory Approach • The Herman approach • Alphabetic Phonics • LANGUAGE! • Lindamood-Bell Programshttp://www.linguisystems.com/getourcatalog.php
Sample 4 cont. • E’s parents consider a computer-based program such as the Touchmath program (www.epsbooks.com) to assist in facilitating his math skills. This program uses a multisensory approach to teaching basic math skills. • E’s parents read grade-level books to him or have him listen to grade-level books on tape in order to support his vocabulary growth. Some ideas for grade level books can be found on the website www.bookadventure.org. On this website BW can find a list of books that interest him on his reading level and also earn points for each book he reads that can be redeemed for awards and prizes. • Mrs. EE have E evaluated to rule out Attention Deficit Hyperactivity Disorder (ADHD) because she is concerned about E’s difficulty sitting still and because there is a high incidence of Attention Deficit Hyperactivity Disorder (ADHD) in children who have dyslexia.
Sample # 5 Student: 16 year, 1 month old male • revealed a profile of strengths and weaknesses that is consistent with a diagnosis of Mixed Receptive/Expressive Language Disorder (ICD-9 code 315.32) and Reading Disorder (unspecified) (ICD-9 code 315.00) Recommendations • F receive language therapy, whether through the public school system or privately, to work on his language processing for in both listening and reading comprehension. • F should benefit from therapy that would give him comprehension support, such as Visualizing and Verbalizing for Language Comprehension and Thinking Program. • Additional reading comprehension strategies would also be useful, including pre-reading, highlighting, outlining, and use of graphic organizers.
Sample 5 cont. Accommodations • F be given extra time on tasks and tests that require memory and recall, especially in math class. Students with language-based disabilities have an especially difficult time memorizing rote facts such as addition and subtraction facts and the multiplication tables. Because of this, F should be allowed to use a calculator for his math assignments, math tests, and classroom work. • F should not be required to copy from the board, an overhead, or from the book. The teacher should provide an outline and copy of the notes. • F be given advance organizers, graphic organizers, and study guides before beginning each new content area in all subjects. He will need these to organize daily reviews at home.
Sample 5 cont Accommodations cont • 4. F have access to a note taker for class lessons. • 5. F have the option for a foreign language requirement waiver exemption or to take replacement requirement. A student who has a language-based disability in his native language will experience it in a foreign language as well. For a student who is struggling with English, learning a foreign language is typically extremely difficult. • 6. F’s academic progress monitored regularly to ensure that accommodations gives are effective. • 7. F will need to have extra time and possibility other accommodation if he takes nationally standardized tests such as the Scholastic Aptitude Test (SAT). Refer to www.ets.org • for further information on accommodations for high-stakes testing.
