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.

Automaticity/Fluency – 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

Digital Assessment Tools

Assessment is a large, important, and oft-debated necessity in education. The traditional view of assessment hinged strongly on summative evaluations -  assessments after the fact, such as a comprehensive exam or final paper. However, the current best practice in evaluating learning is to deploy frequent and thoughtful formative assessments, where teachers build in "check-in points" during the learning process that can be used by instructors to improve their teaching and by students to improve their learning. The goal of this evaluation framework is to inform the educator of what specific needs are present in their students and whether they need to augment their future lessons in response to those needs. It is important to note that the post-evaluation reflection and intervention is the defining feature of a formative assessment. Measuring student performance or collecting data is not formative unless you use the information to help your students.

In today’s classrooms there are a variety of tools to help teachers integrate formative assessments into their curriculum, as well as to gather and organize the data these assessments generate. Some of my favorite tools are discussed below:

Socrative

Socrative describes itself as a digital assessment tool that uses "real time questioning, instant result aggregation and visualization, [so that] teachers can gauge the whole class’ current level of understanding." One strong merit of this application is its flexibility, in that it can be used on multiple platforms, including smartphones, tablets and computers. Furthermore, it allows for personalization and differentiation of the learning process by allowing teachers to create their own assessments based on the specific needs of their students.

Formative

Formative is an exceptional tool to help teachers devise and distribute engaging assessments. The evaluation process is simple with Formative. Within the app a teacher is able to create an assessment, distribute it to students and respond with real time feedback. Formative is also aligned with the principle of Universal Design for Learning that calls for students to be allowed to display their knowledge in multiple ways. Thus, formative allows students to respond to assessment prompts by writing, drawing, or by submitting pictures. Furthermore, Formative is aligned with Common Core and NGSS, and also helps teachers in their pursuit of a paperless classroom.


Exit Ticket

Exit Ticket is a tool that allows teachers to create formative assessment measures, administer them during class periods, and glean real time data about student performance. The types of evaluation tasks a teacher can create are organized into pre-assessments, checks for understanding, tasks to promote discussion, and mid-way checkpoints. Once a student completes an assessment, both the student and the teacher will receive real time data on the student’s understanding of the concepts being taught. Furthermore, Exit Ticket also allows teachers to differentiate their assessments to meet the diverse needs of their student population. For example, using the Groups add-on, teachers can provide special accommodations to sections of their class. When authoring a list of questions, the teacher is able to then customize what questions each group will see.

The Numbers Game: Standardized Testing and Student Ability

Unless you happen to be particularly interested in educational policy in the state of Texas, it's likely that you missed news of a legislative hearing that took place in Austin in June 2012. The Texas House Public Education Committee had met to interview experts about the relationship between learning and standardized testing. Although Texas had injected new rigor into its state-wide tests, student achievement wasn't improving and the committee wanted to know why.

Dr. Walter Stroup, a tenured professor at the University of Texas, was one of those experts. When his turn came, he spoke about what standardized tests do and what they don't do. His research, he said, indicated that tests don't measure what the test-taker has learned. They measure how good the test-taker is at taking tests.

This was a controversial statement (particularly to an organization that had invested tens of millions of dollars on the tests in question), and Stroup's testimony launched a complicated series of events. A recent, lengthy article in the Texas Observer provides detailed information about the fallout, which is ongoing. But regardless of how things continue to play out in Texas, Stroup's perspective on testing reflects, in many ways, our perspective on assessment at the Yellin Center.

Assessments are the cornerstone of our work, and assessments include numbers. But, as each of the students and families with whom we work has no doubt heard Dr. Yellin say, "We're not big numbers people." This perspective is evident in our reports. We don't put the tables of scores front and center; instead, they appear in the back of the report. This format is deliberate. We don't present scores first because our reports are written to capture our authentic, three-dimensional impressions of a student and her mind, and numbers often fail to tell the whole story.

In fact, sometimes numbers tell a story that can be misleading. This can happen for myriad reasons, but here is one example: If a student has an expressive language disability, she'll have difficulty expressing her ideas. She is unlikely to be able to communicate the complexity of her thoughts and cognitive processes using language. But if she is given a full-scale IQ measure, she'll have to use words and sentences to respond to much of the test content. Her overall score is likely to be low because even if she is able to think of the right answers, she may not be able to articulate them. Her oral and written output will not reflect the intricacy of her mind. Simply reporting a low IQ score obtained with such measures for this student without putting this score in the context of her expressive language difficulties would do her an injustice.

We see this kind of scenario frequently at the Yellin Center. Parents will bring us their student and explain that the standardized test scores they've seen just don't fit the child they know. And so, we set to work. It's true that many of the measures a student completes during an assessment at the Yellin Center are standardized. But our clinicians are equally, if not more, interested in the qualitative information that can be gleaned than in the scores the measure yields. We analyze errors to find patterns, and we ask questions that many assessors may not, so that we can figure out how students attained the right answers and which aspects of tasks gave them difficulty. This approach allows us to view scores as just one piece of the puzzle as we work to determine an accurate, actionable cognitive profile for each student.

As Dr. Stroup suggests, standardized tests serve a purpose, but they shouldn't be used as standalone measures. It's pretty nice when a renowned expert affirms something you've been saying all along.

Ten Signs: When To Seek Help for Difficulty In School

How can a parent know if the time is right to seek help for difficulty in school? The honest answer is that every child (and every situation) is different, but if you are having significant or persistent concerns about a student, no matter their age, academic level, or context, we strongly recommend speaking with a qualified professional to ensure that your child is receiving the appropriate support he or she may need to excel in their educational pursuits. Sometimes, it can be important to seek help from professionals working independently of your child's school if you have concerns that the school is not meeting your child's needs, and especially if faculty and administrators do not share your level of concern.

The Yellin Center has compiled a list of ten signs parents and educators should be on the lookout for in students who are experiencing some difficulty in their day to day school or home lives. If more than a handful of these statements are accurate depictions of a student in your life, Dr. Yellin recommends you seek out professional care.

Ten Signs: When To Seek Help for Difficulty In School

1. Stomach aches, headaches or other symptoms of minor illness that occur consistently on Sunday nights, Monday mornings, or when working on projects or preparing for school
2. Feeling stressed or generally anxious
3. Homework and school projects taking much longer than expected on a regular basis
4. Not reading for pleasure, and not feeling joyful about learning or new experiences, generally
5. Diminished self-esteem
6. Low motivation
7. Grades and test scores are not reflecting effort (especially), or knowledge
8. Evidence of strong verbal skills paired with poor writing
9. Knowing subject material one week but completely forgetting it in the following week
10. Seemingly performing well in school, but completely "falling apart" -- emotionally, academically, or otherwise -- at soon as at home

-Jeremy Koren

AAP Updates Guidelines for Diagnosis and Treatment of ADHD

The American Academy of Pediatrics recently released new guidelines for the diagnosis and treatment of ADHD (Attention Deficit Hyperactivity Disorder). These are intended to update and integrate two separate sets of guidelines for the diagnosis and treatment of attention difficulties which date to 2000 and 2001, respectively.

The new guidelines still rely upon the definition of ADHD that appears in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. We have not been big fans of relying solely on this approach to diagnosis, which involves counting symptoms of inattention, hyperactivity, and impulsivity and then looking to see if these symptoms have been present for a number of months in more than one setting (such as both in school and at home). While this approach can be very helpful, we don't think it goes far enough towards truly understanding how attention impacts behavior and learning.

We have always preferred to look at attention from a different, more functional perspective, which considers three primary areas -- mental energy controls, processing controls, and production controls. Within each functional area, we break down areas of strength and weakness, so that we consider a broad array of skills and competencies.

When we look at mental energy controls, we consider not just attentional consistency, but also alertness, mental work stamina, and sleep/arousal balance. We sometimes discuss these factors in terms of whether an individual has sufficient cognitive "fuel" to power their tasks.

When we look at the processing controls of attention, we examine such areas as saliency determination, processing depth, focus on detail, cognitive activation, focal maintenance, and satisfaction levels. These considerations can be viewed as the camera lens that a student will bring to his or her work. Does it focus at the right depth for the task at hand?

We examine production controls by reviewing an array of skills which include previewing, facilitation, pacing, self-monitoring, and inhibition. These are the "output" skills that impact academic performance and classroom behavior.

As a practical matter, we believe that looking at functions is a more helpful approach than just counting symptoms, and the new AAP guidelines do seem to move in that direction. For example, they urge that physicians look at other causes for the symptoms commonly attributed to ADHD, such as learning, emotional, and physical conditions. They also note that special consideration needs to be given to both young children and teens, and they expand the age range in which attention problems should be considered to ages 4-18 (from ages 6-11). The new guidelines also acknowledge advances in medication for attention problems and offer guidelines for physicians as to the best initial approaches for children of varying age groups.

Assessing Kindergarten Readiness

New York's Board of Regents, the governing body for the state education system, is considering a proposal at its meeting today that would include assessing all children entering kindergarten to determine their readiness for school. This would move beyond the basic assessments that are now done to look at whether a child may have a disability or limited English language.

We think this is a fine idea, so long as the more extensive assessments are used as a starting point to guide interventions with appropriate follow-up. We already know that all children learn differently, and that young children, in particular, have a wide range of abilities. By identifying early readiness skills schools can provide teachers with helpful data. According to the proposal before the Regents, this assessment would look at language and literacy development, cognition and general knowledge (including early mathematics and early scientific development), approaches to learning, physical well-being and motor development (including adaptive skills) and emotional development. It would not be used to postpone entrance into kindergarten. According to Newsday, this new extended assessment process would affect about 190,000 entering kindergarten students each year and the funding would be provided as part of a package of federal grants designed to broadly benefit early childhood education.

Learning and the Brain

I recently returned from the Learning and the Brain: No Brain Left Behind Conference in Cambridge, Massachusetts where I had a chance to hear about the rapidly expanding research findings in the fields of neuroscience, evaluation, and education. Applied imaging techniques like functional MRI and other technologies to measure brain activity are providing a great deal of insight in the fields of brain development, brain maturation, development of academic skills, normal variations, and learning differences/disabilities. I also had a chance to spend a full day focusing on the latest developments in reading diagnostics and dyslexia.

One clear message that emerged from the Conference is that traditional testing of students' abilities or achievement is not specific or sensitive enough to get at the kinds of variations we need to be appreciating to decide on appropriate interventions for individual students. Assessments that identify strengths as well as specific weaknesses will be critical in making treatment decisions as well as allowing for the kinds of research that has to happen so that we can move toward research based decisions in determining which strategies are most effective.

The many attendees at the Conference included a number of Learning Specialists and Clinicians who worked with me when I served as National Director of the All Kinds of Minds Clinical Programs, which were the predecessor to The Yellin Center.

AKOM Alumini: Paul Yellin, Molly Warner, Sarah Eskin-Drake, Hollis Dannaham, Craig Pohlman, and Jennifer Bitner

Much of so-called brain based interventions or educational strategies often grow out of personal agendas, individual points of view, or marketing initiatives, rather than unbiased peer reviewed research. But I was pleased to leave the Conference with the strong sense that interest in doing rigorous study of educational practice and interventions and linking these to the newest findings in neuroscience is increasing. As pockets of research collaborations between scientists and educators are appearing around the world, those of us in the field will have a richer, more vigorously derived body of knowledge to draw from as we make day-to-day decisions to best serve the children and families in our schools and clinics.

A Terrific Week in Hamilton, NY

I spent the last week in June, together with one of our Learning Specialists, in beautiful Hamilton, NY, where we met with a team from the Hamilton Central School District – Principals, Learning Specialists, Reading Specialists, Classroom Teachers, and the District Psychologist, Occupational Therapist, and Superintendent of Schools. Joining us was a representative from the Madison-Oneida BOCES (Board of Cooperative Educational Services).

Over the course of the first day, I gave a series of presentations that included an overview of the emerging neuroscience about learning and its implications for classroom practice and assessment. I spoke about the basis of our clinical framework and how it is compatible with Response to Intervention (RTI) and consistent with emerging scientific knowledge. Particular attention was paid to looking at what the District was already doing for struggling students and bringing to these steps the notion of applying the concepts of differential diagnosis and neurodevelopmental profiles to an analysis of learning differences – with a particular focus on Tier 3 of RTI.

The lecture portion of our training visit looked in depth at the eight neurodevelopmental constructs at the core of our clinical model, and their linkages to the educational process and academic difficulties. We described how to apply this model to elucidate the specific breakdowns underlying each student’s academic difficulties. We also demonstrated how to develop individual plans based on a deep understanding of each student’s unique profile of strength and weaknesses. We ended our first day by discussing the issues faced by a specific student with long-standing difficulties, whom we would be assessing the next day. Together, we planned the assessment.

Our second day was spent assessing this student, who had been selected by the District, with the consent of his parents. We assessed two more students on the remaining days of our five day visit, (ultimately including both elementary and secondary students). For each assessment, the student’s parent(s) observed from one room and the Hamilton team from another location. For the remaining assessments, members of the Hamilton clinical team (the District Psychologist and Learning Specialists) participated in various parts of the assessment under the supervision of Yellin Center clinicians.

It was a gratifying experience and one that everyone agreed worked well for the Hamilton team. It would not have been possible without the terrific administrative support and troubleshooting from the District staff that made it possible for the parents and educators to observe the assessment process via remote technology, without intruding on the students’ experiences. The Hamilton Central School District is also the beneficiary of extensive professional development support from Colgate University, located in Hamilton. As both a visiting clinician and a proud parent of a Colgate graduate, I can appreciate the incredible community of support they provide to their local District. We also can’t thank our hosts enough for their hospitality and wonderful company.

Our next step will be a presentation, together with the Hamilton Central School District, at the New York State School Boards meeting in October in New York City, as an example of “best practices” in intervention and implementation of RTI. Our Yellin Center team is looking forward to continuing our work with these dedicated educators and to defining the next steps in our collaboration.

The Future of Assessment

We've written before about the limits of labels, and we continue to encounter parents who are uncomfortable with a special education system that requires that students be "classified" by what purports to be a description of the student's disability.

This coming Monday evening, November 9th, Dr. Yellin will be speaking at REDS - The Resurrection Episcopal Day School, in New York City -- as part of its lecture series entitled "Working Together – The Collaboration among Parents, Teachers, Clinicians and Scientists To Support Learning and Development in All Children”.

Dr. Yellin's talk is entitled The Future of Assessment - What are we really trying to measure and how does it translate to the classroom? He will be looking at what current testing claims to measure and how it should be looking to understand how students' minds really work. He will explain how new findings in neuroscience and brain imaging have enabled clinicians to see how effective interventions can truly change how brains work, and how emerging partnerships between educators and clinicians will enable classroom teachers to benefit from the deeper understanding of learning that science has helped to achieve.

Parents, teachers, and others who are looking for a better understanding of how to link brain science to the classroom should find this a worthwhile evening.