Monday, October 16, 2017

Dyslexia Instruction That Works

A diagnosis of dyslexia can bring with it a range of emotions. Some people are crushed, thinking that their, or their child’s, potential is irrevocably limited. Some are relieved: There’s something empowering about being able to name a condition and, of course, it’s validating to have a professional verify that the affected student isn’t “dumb” or “lazy.” But one of the most common reactions is confusion. Parents may feel overwhelmed and lost. Is there a way to teach literacy skills to a child with dyslexia that really works? If so, how does one find it?

We are happy to say that the answer to the first question is an emphatic “yes!” There are several thoroughly researched, time-tested instructional methods that can help students with dyslexia make sense of language. This instruction can occur in a variety of formats, but parents should always look these indicators of a highly-effective program:

  • Curriculum is multi-sensory, explicit, and structured. Orton-Gillingham, and programs based on it, is the gold standard when it comes to instruction for students with dyslexia. There are lots of curricula (Wilson, Lindamood-Bell, Barton, etc.) that are O.G.-based, so don’t be thrown off by names. But research the curriculum to be sure it is grounded in this solid, well-researched approach.
  • Curriculum includes training in phonemic awareness by itself. Phonemic awareness (skills needed to recognize and manipulate the sounds in language), is a key component of good early childhood instruction, but older students with dyslexia need this kind of instruction, too; their brains are less able to develop these skills simply from exposure to language. Recent research shows that phonemic awareness instruction should happen by itself, not in conjunction with written letters, to be most effective. In other words, both phonemic awareness (sounds) and phonics (sounds plus letters) should be part of instruction.
  • Curriculum is administered by a certified reading or literacy specialist, or by an educator certified in an O.G.-based curriculum. No matter how talented, smart, or well-intentioned, standard classroom teachers and even special education teachers are not trained in the kind of reading instruction children with dyslexia need. (Trust me on this; I used to be one! It wasn’t until I obtained a masters degree in literacy, then was trained in Orton-Gillingham, that I was prepared to teach individuals with dyslexia.) 
  • Other parents give the curriculum a thumbs-up. Ask to speak with parents of other children with dyslexia (not just struggling readers) who have received instruction from the provider you are considering.
So now that you know what to look for, how do you find it? That’s often a little more complicated. High-quality instruction for students with dyslexia can occur in a few different formats.

Services in Public School

Your child is entitled to a free, appropriate instruction from her school, often referred to by the acronym FAPE. This will probably take the form of pull-outs, meaning that a special education teacher or reading specialist will take your child out of her mainstream classes to work one-on-one or in a small group of similar students. Please note what we said above about the qualifications of your child’s instructor. If your district doesn’t provide a qualified reading specialist, you may need to do some research and be prepared to demand that your child receive instruction from someone who is properly trained; this should be set out in your child's IEP.  Most special education teachers are not trained in the specific reading instruction students with dyslexia need.

Dedicated Schools

Special schools for children with dyslexia are few and far between, but if you’re lucky enough to live near one or are flexible and up for a new adventure, this might be worth considering. (Some families even move to new cities in order to be near top-notch institutions!) The benefits of a quality school that is dedicated to dyslexia instruction are enormous. Not only are the teachers knowledgeable and experienced in reading instruction, but curriculum that benefits students with this profile is woven into every subject. Most schools also teach students how to self-advocate effectively and use helpful technology that can assist them in college and beyond. And, perhaps most importantly, students become friends with other bright, creative, dynamic, wonderful kids who share their struggles.

Private Instruction (e.g. Tutoring)

Sending your child with dyslexia to a special school isn’t feasible for lots of families for a variety of reasons. For kids who need help beyond what the special education services in their public school provide, private instruction is a great option. This usually occurs through two channels: established organizations or private practitioners.

Tutoring companies that specialize in reading disabilities, like Lindamood-Bell, can be good options for families. Look for an office that administers lots of benchmark assessments throughout instruction that clearly demonstrate that your child is making progress. Avoid tutoring companies that don’t specialize in reading disabilities; most of these organizations (Kumon, Sylvan, etc.) may provide great homework help for typically developing readers but don’t staff the specially trained teachers students with dyslexia must learn from.

Private practitioners vary enormously in training and quality. One surefire way to find a good one is to check out the International Dyslexia Association’s provider directory. Even if one of these professionals can’t take on another student, they may be able to point you in the direction of someone who can. Another suggestion is to speak with the administration at a school for students with dyslexia or students with language-based learning disabilities. The expert teachers who work at these schools often tutor on the side. If they don’t, chances are the principal knows someone who will.

A few words about scheduling, no matter where your child goes for private instruction:

  • Set up at least two sessions a week initially. For younger children, shorter sessions (30-45 minutes) two or three times a week are better than an hour-long session once a week. Remember that your child will be working hard, and an hour in one go, even for older kids, may be too much at first.
  • Your child will likely be worn out at the end of a school day, so morning sessions work better than after-school sessions for some families. 
  • Some tutors will travel to your child’s school to work with him during instruction from which he gets little benefit, like spelling. While this can be an efficient use of time, some students feel self-conscious about being pulled out of class, making it hard for them to learn.
Summer Learning Opportunities

Summer slide, the tendency of kids to lose some of the skills they worked to gain during the school year, hits students with dyslexia particularly hard. It’s tempting to give kids a break for the summer, but they need at least some opportunities to keep their skills sharp to prevent frustration when school begins again. The summer months are a great opportunity for multiple weekly sessions at Lindamood-Bell or with a tutor. For older learners, excellent schools like Kildonan, the Landmark School, the Brehm School, and the Gow School offer residential summer camps that blend expert literacy instruction with opportunities to explore the arts, play sports, and have fun getting to know  peers with dyslexia.

Look for our post next week on high-tech tools to help learners with dyslexia (and adults!) with literacy demands.

Monday, October 9, 2017

Assessing for Dyslexia

The best kind of intervention is early intervention. When it comes to dyslexia, though, this can be tricky because dyslexia can’t be diagnosed until a child begins to show significant difficulty learning literacy skills. That doesn’t mean parents have to simply watch and wonder until first or second grade, though.

The earliest common symptom of dyslexia is late speech (though not all late talkers have dyslexia, and not all children with dyslexia were late talkers). There is a wide range of “normal,” but Reading Bright Start, a useful site for parents of children from birth to age five, provides some useful milestones to look for.

Kids may begin to speak later than expected for a variety of reasons, but no matter the cause it’s a good idea to have a child evaluated as soon as there is concern. A quick consultation with your child’s daycare or preschool teacher can be valuable; these professionals have worked with countless children and usually have a good sense of whether a child is behind or not. Free early intervention evaluations are available in every state for young children. Young kids just beginning school should be monitored, too. According to the International Dyslexia Association, at least one of a handful of measures* should be given to all school-aged children, beginning in kindergarten, to identify kids who are at risk for reading difficulties.

Speech and language sessions for young children don’t focus much on reading skills. It’s too early for that. Instead, the therapist helps children to understand the sounds that make up language, which is a critical foundation for literacy down the road. Strengthening skills early can prevent or lessen many struggles children may otherwise have when they begin school.

Sometimes, though, the signs of dyslexia aren’t addressed until elementary school (or later). Never fear, though; with the right instruction (look for our upcoming post on that topic) there is still good reason to believe that older kids can learn important literacy skills at any age. Recent neurological research indicates that brains are plastic throughout much of our lives—great news for adults!

When seeking out an assessment for an older child, a good assessment should probe all areas in which the child appears to be struggling. An assessment that only seeks to determine whether a child has dyslexia may miss other important issues that are contributing to that child's academic struggles.  Among the aspects of an assessment that are most helpful in determining whether a child has dyslexia or another language based learning difficulty are the following:

Intelligence – A child with a cognitive deficit is not considered to have dyslexia.

Oral Language Skills – It’s important to rule out a language impairment. Children with dyslexia typically have strong higher-language skills, though they may struggle with building blocks, like word pronunciation.

Phonological Processing
– These measures usually don’t involve written language at all; rather, the assessor will examine the way your child identifies, pronounces, recalls, and manipulates the sounds in language. An assessment of phonological processing must be a part of a dyslexia evaluation.

Word Recognition – This means reading familiar words in isolation.

Decoding – This means reading unfamiliar words in isolation. Students may be required to read “nonsense words,” too, to ensure that they aren’t simply recognizing the word’s shape instead of actually interpreting the individual letters.

Spelling – This is usually one of the toughest tasks for children with dyslexia.

– Some students with dyslexia can stumble along with good accuracy, but measures of fluency will reveal how taxing literacy processes are for them.

Reading Comprehension – Children with dyslexia usually have the cognitive skills to understand grade-level text but score poorly on measures of comprehension measures. This is an artifact of their difficulty decoding the text.

Vocabulary Knowledge
– Most children with dyslexia have smaller vocabularies than their peers because of their difficulty processing oral language and accessing written language.

The assessor should also ask about physical and emotional health and family history and educational history. Issues with any one of these areas can interfere with a child's learning.

If it turns out that your child does need special reading instruction, the resulting report will be invaluable. It will help service providers make a treatment plan, and it will demonstrate your child’s needs if you need to negotiate with the district to get your child the services s/he deserves. We have countless posts on this blog about all aspects of assessments and special education laws. Start with the "search" feature on the right hand side of this post, looking for posts on subjects like "IEE" (Independent Educational Evaluation) and "IDEA" (Individuals with Disabilities Education Act).

So what happens if your child is diagnosed with dyslexia? Look for our next post on effective instruction for dyslexic learners.

*Predictive Assessment of Reading (PAR); Dynamic Indicators of Basic Early Literacy Skills (DIBELS); Texas Primary Reading Inventory (TPRI); and AIMSweb screening assessments

Photo by Christin Hume on Unsplash

Monday, October 2, 2017

October is Dyslexia Awareness Month

It’s Dyslexia Awareness Month! During October, we’ll be running a series of posts about this common and commonly misunderstood condition.

First, test your knowledge. Below are some statements you may have heard about dyslexia. Can you tell which ones are myths?

  • Kids with dyslexia are mentally handicapped or lazy.
  • Boys are more likely to have dyslexia than girls.
  • People with dyslexia see letters backwards.
  • Individuals with dyslexia can read better with the help of colored films.
  • Dyslexia can be cured.

OK, that was a trick, because ALL of the above statements are FALSE. In my work with students with dyslexia, first at Columbia University’s Teachers College, at The Yellin Center, and now at Hillside School in Colorado (where we serve only young people with dyslexia), I’ve heard a lot of misconceptions about this disability. So what is dyslexia? And what isn’t dyslexia? The answers may surprise you.

Dyslexia is a genetic, lifelong, language-based disability. It is neurological in origin; brain scans of people with dyslexia show that they process language differently than typically-developing youngsters, even when they’re just listening or speaking and not reading at all! Individuals with dyslexia are most certainly not cognitively limited. In fact, a person must have average to above-average intelligence in order to be diagnosed with dyslexia. And dyslexia is positively correlated with creativity, which will not surprise anyone familiar with Richard Branson, Tom Cruise, Pablo Picasso, Stephen Spielberg, and Henry Winkler, (all of whom have dyslexia).

The International Dyslexia Association, an outstanding resource, estimates that 15-20% of the population has dyslexia. Only 13-14% of the school population receives special education services for literacy because of dyslexia, though. (Look for our upcoming post on instruction that words for students with dyslexia.) This reason for this disparity is two-fold: some students with dyslexia have a fairly mild impairment and don’t qualify for special services, and some students with dyslexia go undiagnosed. This is especially true for students with attention deficits or who are viewed as having “behavior problems” or those in ESL classes. Dyslexia affects boys and girls in equal numbers, though boys are more likely to receive a diagnosis, possibly because girls “fly under the radar” more frequently.

Interestingly, speakers of any language can have dyslexia, even those who speak logographic languages (which use a different symbol for each word, like Chinese) instead of letters. This is because dyslexia is a disorder of language processing, and that means language in all its forms, even oral language. Most individuals with dyslexia were late talkers as young children, likely because they struggled to recall and produce the sounds that make up words. (Look for our upcoming post on assessment to learn more about the early signs of dyslexia and when to seek a professional opinion.) Dyslexia is considered a reading disability because this task is particularly difficult for affected individuals and has an enormous impact on their lives, but spelling and even pronouncing words can pose serious challenges as well.

Dyslexia can occur alongside other difficulties, and comorbidities like ADHD and dysgraphia are common. Many individuals with dyslexia struggle with math, too. It’s difficult to tell whether there is a causal relationship because an individual with dyslexia's difficulty processing language may make it hard for them to benefit from instruction across subjects. However, I’ve worked with a number of  students with dyslexia who were impressive mathematicians. It’s useful to remember that dyslexia affects each person differently.

Be wary of anyone claiming that they can help learners with dyslexia with the aid of special glasses or colored films. Dyslexia is a neurological condition and has no relationship to vision. In the reading world, common knowledge is, “If the eyes work for seeing, they’ll work for reading.” Of course any student struggling with reading should have a vision screening to rule out poor vision as a factor, but a person with dyslexia with 20-20 vision will still have difficulty reading written words. There is no evidence to suggest that colored films do anything more than hold a child’s attention for a few minutes while they’re still novel. And the belief that students with dyslexia see letters backwards is completely false. Children with dyslexia do reverse words when reading and writing, but typically-developing readers do, too. Learners tend to stop reversals when the sequence of letters begins to have significance for them, and this understanding takes much longer for students with dyslexia to develop.

Finally, an individual with dyslexia has dyslexia for life. There is no “cure,” but this doesn’t mean there is no hope. With the right instruction, almost all children with dyslexia can learn strategies to read and write and manage their dyslexia in a way that allows them to access the kind of opportunities that interest and suit them.

Stay tuned for upcoming posts throughout the month of October about dyslexia!

Wednesday, September 27, 2017

ADA Accommodations for Good Students

Almost exactly two years ago, in September 2015, we wrote a post about new guidelines from the U.S. Department of Justice, which were a response to questions about testing accommodations under the Americans with Disabilities Act (ADA). The Justice Department guidelines were very clear and set out the basic principles of the ADA and how they should be applied to testing and accommodations.
Still, we recently had a conversation with a private school parent where the question was raised as to whether a student who was doing well -- keeping up with class work and getting good grades -- would be entitled to testing accommodations under the ADA. So, let's look again at what the law requires, quoting directly from the Justice Department guidelines:

  • "Under the ADA, an individual with a disability is a person who has a physical or mental impairment that substantially limits a major life activity (such as seeing, hearing, learning, reading, concentrating, or thinking) or a major bodily function... 

  • "To be 'substantially limited' in a major life activity does not require that the person be unable to perform the activity. In determining whether an individual is substantially limited in a major life activity, it may be useful to consider, when compared to most people in the general population, the conditions under which the individual performs the activity or the manner in which the activity is performed. It may also be useful to consider the length of time an individual can perform a major life activity or the length of time it takes an individual to perform a major life activity, as compared to most people in the general population. 

  • "A person with a history of academic success may still be a person with a disability who is entitled to testing accommodations under the ADA. A history of academic success does not mean that a person does not have a disability that requires testing accommodations. For example, someone with a learning disability may achieve a high level of academic success, but may nevertheless be substantially limited in one or more of the major life activities of reading, writing, speaking, or learning, because of the additional time or effort he or she must spend to read, write, speak, or learn compared to most people in the general population."

Keep in mind that the ADA is the primary disability law covering most private K-12 schools, although religious schools are exempt from the ADA. A good explanation as to how disability laws apply to private schools was prepared by the National Association of Independent Schools. 

Friday, September 22, 2017

The Phenomenon of Motivated Forgetting

Every fall, students return to school with a little bit less academic knowledge than they left with in June. There is no shortage of reasons or hypotheses for why this happens, but three researchers recently wanted to look more closely at what might be getting in the way of students taking their learning with them across time. Ramirez, Jin, and McDonough, at The University of California and The University of Alabama,* explored the topic of motivated forgetting in college students – the concept that we may deliberately remove “unwanted memories” from our awareness because unpleasant memories may threaten our sense of self. 

In general, motivated forgetting is “the process by which people have difficulty recalling information and memories for events that are unpleasant, painful, or generally threatening to the self-perceptions” that we work to build about ourselves*. In other words, we are motivated to forget information that is damaging to our ego, or sense of self. As an example, researchers have found that people are less able to recall information from historical passages about atrocities when the perpetrators of those atrocities belong to the individual’s cultural group. The idea behind this is that it would be damaging to that person’s sense of self or identity to know that information, and so they are unconsciously motivated to forget it. When this research was applied to feedback about behaviors, psychologists found that even though people are just as good at recalling negative and positive feedback about behaviors peripheral to the self (i.e., not that important to one’s ego), they had a harder time recalling negative as compared to positive feedback regarding behaviors that are central to their sense of self. In other words, if I think of myself as a very honest person, and I am given feedback about how I engaged in a dishonest behavior as well as feedback about how I engaged in honest behavior, I am going to have a harder time remembering the negative feedback. This would not be the case if honesty was not one of the most important traits I think about when I consider my sense of self.

Interesting, but how does this relate to students' loss of academic knowledge after their summer break? 

Ramirez, Jin, and McDonough wanted to see whether students in a difficult math course suffered from motivated forgetting after the semester ended (i.e., during summer break). They hypothesized that students with a high math self-concept who felt stressed out by the course would have a harder time remembering what they learned as compared to students who did not consider math as integral to their sense of self, even if they were just as stressed out. The researchers tested this by giving the students an extra final exam, two weeks into their summer break (lucky them!). They found that, indeed, students who were more stressed out by the coursework were more likely to forget information, but only if they had a higher mathematics self-concept. Students who did not consider math an integral part of their identity were not affected by the stress.

This finding may seem a little surprising, since we would expect that students who care deeply about a topic will remember more of it. However, this study has pointed out for us that the more deeply we care about a subject or the more we feel it is an integral part of our self, the more we may be affected by ongoing stress about that subject or relevant coursework. Humans are always trying to protect their egos, so it makes sense that we would push out information after it is no longer critical if that information is putting our sense of self off balance. In other words, the students in the study didn’t forget the information until after the course ended because prior to that, it was critical to their grades. Once summer hit, it was relatively safe to forget. However, looking at the bigger picture, we know that math is cumulative, and the information learned in one course is important to take with us to the next, especially for the students in the study, who were primarily going towards majors and careers in fields related to STEM. 

The researchers published this work with the hope that educators will work on implementing stress-reduction techniques into their teaching. They also briefly discussed the concept of teaching students to interpret stress, and even failure, as a positive rather than a negative force. Ramirez, Jin, and McDonough emphasized that, based on research done previously, it’s important to help students “approach classroom stress as a normal challenge that is a part of the learning process rather than a threat to their self-perception” so that they can avoid this phenomenon of motivated forgetting*** . We’ve written many times before about the concept of mindset, originated by Dr. Carol Dweck, which can be a useful classroom teaching tool for helping students at all grade levels learn about the positive value of failure. Ramirez, Jin, and McDonough make an even stronger case for its presence in the classroom, so as we settle in to the school year, let’s remember to give our students a reason to embrace the learning process, even if it is a little stressful.

* Ramirez, G., McDonough, I. M., & Jin, L. (2017). Classroom stress promotes motivated forgetting of mathematics knowledge. Journal of Educational Psychology, 109(6), 812-825. 
** p. 812
*** p. 821

Wednesday, September 13, 2017

The NVLD Project

We recently learned of the NVLD Project, founded in 2013 by Dr. Laura Lemle, whose daughter was diagnosed with a non-verbal learning disability (NVLD) when she was five years old. Dr. Lemle, now in the real estate business, has a PhD in clinical psychology.

This nonprofit organization offers informational workshops, supports research, and has a blog where an array of writers share their knowledge and experiences with NVLD.  Long term, the NVLD Project seeks to have NVLD included as a specific disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the "bible" of medical diagnostics developed by the American Psychiatric Association. The NVLD Project notes that such recognition "will allow people who have NVLD to be covered for clinical care and it will foster more rigorous empirical research on the causes of and best treatments for NVLD."

So what, exactly, is a non-verbal learning disability? First, it involves a significant discrepancy between verbal and perceptual reasoning abilities, where the individual has strong abilities in such verbal realms as reading, vocabulary, and memory, but struggles with spatial, mathematical, and certain "big picture" tasks. In addition, organization, executive functions, and social skills can be areas of difficulty. An extensive discussion of the components of a non-verbal learning disability is set forth on the Project NVLD website.

The difficulties that characterize NVLD can be present in other learning and social disabilities, and distinguishing among the various labels for disorders may be less important than understanding the strengths and difficulties faced by each individual and developing specific strategies and supports to build on his or her strengths and to bypass or improve challenges. Still, understanding NVLD and researching why and how NVLD arises is an important first step to remediating this constellation of difficulties. Likewise, supports for individuals and families dealing with NVLD can be extremely helpful.

Monday, September 11, 2017

September 11, 2017

Today is September 11th and the horror and bravery of that date in 2001 and the days that followed has not diminished with the passage of 16 years. As we remember where we were on the date our city and our nation was attacked, and in many ways changed forever, we look back with excerpts from a post we wrote back in 2010.

September 11th - A Personal Story

Tomorrow is the ninth anniversary of the September 11th attacks, an event that has become associated with many things since that horrific day -- courage, loss, terror, war, and retribution -- just to name a few. We suspect that you have no trouble remembering where you were when you first heard the terrible news. We were all touched by this event. But for those of us in New York, Washington and  Pennsylvania, and especially for those whose loved ones were lost  in the towers or on the ill-fated planes, there was, and still is, a particularly personal resonance to the events of that day.

Some of you may have seen a hard-hat sitting on a shelf in Dr. Yellin's office. On September 11, 2001 Dr. Yellin was the Chief Medical Officer of  NYU Downtown Hospital, located just three blocks from the World Trade Center. He was attending a meeting in mid-town Manhattan, about three miles north, when his Chief of Nursing called his cell phone to report a fire at the World Trade Center. He promptly left his meeting and took a subway train downtown to the hospital, knowing that the hospital emergency response team would be moving into action, but completely unaware of the scope of the disaster. He emerged from the subway into streets of chaos, and got inside the hospital building just as the first of the towers fell. It was pitch black in the daytime, with a thick cloud covering the glass walled lobby. The hospital staff was geared up to deal with injuries and survivors, but there were only a handful of survivors in those first, awful hours. As the scope of what had happened became clear, teams of doctors, nurses, and support personnel  went to the remains of the towers to see what they could do. Dr. Yellin joined them for a time and was handed a hard-hat by a Con Edison worker; debris was everywhere.

Time became irrelevant. The mission to save survivors became one, instead, of serving the recovery teams and the local residents, who had no electricity or other services in what was, for many months, a disaster zone. Three days later, when Dr. Yellin made it home by train in a pair of dusty scrubs, people kept shaking his hand and thanking him. He knew that there had been far too little for him and his team to do on that fateful day.

Recalling the events of September 11th or seeing the devastation from the recent hurricanes can be unsettling for both children and adults. Our colleagues at the American Academy of Pediatrics' "Healthy Children"  website have helpful information about how parents can speak to their children about disasters of all kinds. 

Photo: SMU University Libraries