Dyslexia: Your Questions Answered

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DyslexiaYour Questions Answered

• Dyslexia as understood in a
• Neuro-developmental Model of Assessment and
  Interventions

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Agenda

• Housekeeping
• Introduction of Lexicon Team
• Presentation
• Discussion

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Introduction Lexicon Team

• Rudolf Stockling
• MSc (Psych) MAPS Registered Psychologist NSW
  Australia
• Educational Psychologist
• Director of Assessment Lexicon Reading Centre
• Praveen Vasanthakumari
• MSc (Psych), Sp. Ed., Education Therapist
• Learning Specialist
• Saloni Krishnan
• MSc Cognitive Sciences BASLP
• Communication and Speech and Language Therapist
• Rania Anis Bin Taleb
• MSc SPM PMI Member
• Managing Director

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Presentation Outline

• The Neuro-developmental Model
• Recap
• Dyslexia What is it ?
• Scientific Theories of Dyslexia
• Dyslexia Who has it ?
• Characteristics of Dyslexia
• Dyslexia What to do about It ?
• A) Assessment b) Interventions
• 5. Discussion

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1. Neuro-developmental Model

• Eight Constructs
• ?? Attention
• ?? Higher Order Cognition
• ?? Language
• ?? Memory
• ?? Neuro-motor Function
• ?? Social Cognition
• ?? Spatial Ordering
• ?? Temporal-Sequential Ordering

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2. Dyslexia What is it ?

• Scientific Theories of Dyslexia

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• I saw a red surfbord laying on the rode. It look
  like my friend so I hid it in the bushis just in
  case. When I whent to the beach I saw my frend
  Spence he had his bord.

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Visual problems in reading
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Definition of the
International Dyslexia Association

• Dyslexia is a specific learning disability that
  is neurological in origin.
• It is characterized by
• difficulties with accurate and/or fluent word
  recognition and by poor spelling and decoding
  abilities.
• These difficulties typically result from a
  deficit in the phonological component of language
  that is often
• unexpected in relation to other cognitive
  abilities and the provision of effective
  classroom instruction.

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How Widespread is Dyslexia?
Likely to be dyslexic
w/ reading disability

• Current research shows that approximately 15-20
  of the population has a reading
  disability.
• Of that 15-20, 85 are dyslexic

School population
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Neural Basis of Reading

• Left inferior frontal gyrus
• Left temporo-parietal cortex
• Left infero-temporal cortex

Speech sounds
Alphabetic code
Visual word form
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Dyslexia
a specific learning disability that is
neurological in origin
Brain Briefings, Society for Neuroscience
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Major Current Dyslexia Theories

• 1.Phonological Deficit Hypothesis
• 2.Double Deficit Hypothesis
• 3.Automaticity Deficit Hypothesis
• 4.Cerebellar Deficit Hypothesis

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1. The Phonological Deficit Hypothesis

• Cause of Reading difficulties is in
• phonological processing such as
• problems in
• sound segmentation
• and
• in word blending
• both are critical for the development of reading
  and spelling.

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2. The Double Deficit Hypothesis

• Two crucial deficits
• (i) Phonological processing problems
• (ii) Rapid processing problems
• (naming speed, comparing same different speed)

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3. The Automatization Deficit Hypothesis

• The concept of an automatization deficit
  explains the range of problems shown by dyslexic
  children.
• Dyslexic children will have difficulties on any
  task that requires automatisation of skill.
• Even on task where they appear to be performing
  normally they have to try harder to achieve the
  same results.

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2. The Cerebellar Deficit Hypothesis

• Cerebellum may be an underlying causal factor for
  all the characteristics explained by the other
  theories
• Cerebellum has many functions such as balance,
  motor control etc.

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Cerebellum
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The role of the cerebellum in dyslexia

• Its role in making processes automatic relates
  to the difficulty experienced for Dyslexic people
  to become fluent readers.
• Why specific to reading?
• Severe problems arise for reading and spelling,
  because they require both good phonological
  skills and good automatisation - double
  difficulty!

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Questions

• How different are these theories?
• Is this like the four men and the elephant?

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Six Blind Men
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Difficulties experienced by dyslexic children
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Answers

• Answer
• (i) Different theories are at different levels of
  explanation
• (ii) The type of explanation that is most
  valuable depends upon the question you are
  asking!
• (iii) It may be that different dyslexic children
  suffer from different underlying causes.

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Why Are many Dyslexic Children Clever?!

• The cerebellum is needed for unconscious
  development of skill fluency. Skills can be
  acquired without the cerebellum .
• The traditional seat of intellectual behaviour,
  the frontal lobes of the cortex, may well be
  completely spared, or even over-achieving.
• IQ, metacognition, strategy use, knowledge etc.
  are all fine.
• Dyslexia is not related to Intelligence

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3. Dyslexia Who has it ?

• Characteristics of Dyslexia
• How do we recognize a child with dyslexia

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2-D learners

• Have talent for language
• Good at sequence and time and events
• Memory for abstract symbolsletters stand for
  something

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3-D learners

• Have a talent to make, do, draw, build
• Often intuitive, creative, and good imagination
• May take up to 1500 repetitions of seeing a word
  or letter to remember it
• Do not do well with idioms
• knock it off
• Often seen as lazy or immature

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Not a Single Pattern that Identifies a Student
with Dyslexia

• Some
• Reverse lettersothers do not
• Show related problems with spoken languageothers
  do not
• Have problems with attentionothers do not
• Have trouble retrieving words to recall them
  quicklyothers do not
• Have trouble with mathothers are talented in math

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Some

• Have problems with organizationothers do not
• Appear insensitive to othersothers are very
  sensitive
• Have a low self-esteemothers do not
• Have difficulty with handwritingothers do not
• Have a slow rate of writingothers do not

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A Student with Dyslexia has a Unique Pattern Much
Like Your Fingerprint

• Person who reads well with poor Comprehension
• Inaccurate reader with ok comprehension
• Extremely slow reader
• Strong speller and the slow reader
• Adequate reader who has difficulty with all
  written expression including copying and spelling
• One that has trouble with all of the above

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Activity 1 Signs of Dyslexia

• 1. Participants describe to each other a child
  they know who has been diagnosed with Dyslexia
• 2. Group discusses the age appropriate warning
  signs described in the handout
• 3. Add any other signs that you have observed
• 4. One member reports to all participants

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Warning Signs in Preschool

• Delayed speech slow to add new words difficulty
  finding the right word
• Mixing up sounds or syllables in long words
• Poor memory for nursery rhymes
• Difficulty learning colours, days of week,
  numbers, shapes
• Difficulty learning how to spell or write name

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Warning Signs in K-3

• Difficulty understanding
• that words can be separated into parts
  (firetruck fire and truck)
• that words can be separated into sounds (tip
  /t/ /i/ /p/)
• Difficulty learning letter names and sounds
• Difficulty reading single words relies on
  context clues to recognize words Cant remember
  sight words
• Slow choppy, inaccurate oral reading
• Difficulty with daily spelling

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Warning Signs Grades 4th High School

• Has difficulty spelling may use simplified
  vocabulary when writing.
• Continues to have reading difficulty
• Lacks fluency reads slowly avoids oral reading
• Avoids reading for pleasure
• Difficulty finding the right word when speaking
• Dreads going to school

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Effects of dyslexia reach far beyond the classroom

• Self-image
• Feelings of being dumb or different
• Feeling of being less capable than they
  really are
• Stress due to academic or social problems
• Discouraged about continuing in school

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Important to remember that

• students with dyslexia can learn
• They just learn in a different way
• Not a disease or result of an accident or injury
  but rather it describes a kind of mind
• Often gifted and productive mind that learns
  differently

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4. DyslexiaWhat to do about it ?

• Assessment of Dyslexia

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What do consider

• Possible other issues / co morbidities
• Cognitive Ability (Gifted / Slow Learner)
• (Language / Non-verbal Issues
• Psychological issues (ADHD / Anxiety Motivation /
  Self Esteem / Family Issues)
• A thorough assessment is essential to determine
  the exact nature of the learning difference and
  to exclude alternative explanations for the
  problem
• A diagnosis leads to a remediation plan
• and
• recommendations for interventions

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Assessment Steps

• Referral
• Data Gathering
• Testing
• Psychological Issues
• Ability (Language, Perceptual, Memory,
  Processing)
• Achievement (Reading / Maths / Listening / Oral
  Language)
• Reading / Writing Behaviour
• Intervention Plan Formulation

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Data Gathering Informants

• Information about the student
• Students work samples, Test Results Reports
• Teachers observations (Interview,
  Questionnaires, Informal)
• Parent (Interview, Questionnaires)

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Areas of Data Gathering

• Vision/hearing
• Teacher reports
• Previous assessments
• Accommodations/
• Modifications (classroom teacher)
• Academic progress reports

• Samples of school work
• Parent conferences
• Speech/language (previous referrals)
• OT, other interventions

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Assessment Instruments

• Have to be valid
• Culturally appropriate
• Assess the specific areas of educational need
  not to provide a single general IQ
• Have to accurately reflect students aptitude,
  achievement level and specific learning profile

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Assessment of General Issues

• Psychological Questionnaires (Parents / Teachers
  / Students) (Achenbach System of Empirically
  Based Assessment ASEBA)
• Learning Style (Parents / Teachers / Students)
  Cognitive Processing Inventory (CPI)
• Ability Wechsler Intelligence Scales (WISC-IV,
  WPPSI-III)
• Achievement (Wechsler Individual Achievement Test
  WIAT-II)
• Others depending on need

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Literacy Specific Assessment Instruments

• Reading single words in isolation
• Wide Range Achievement Test 3 (WRAT-3)
• WIAT-II Word Reading
• Word Decoding
• WIAT-II Pseudoword Decoding
• Phonological Awareness
• Phonological Awareness Test (PAT)

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• Letter Knowledge
• WIAT-II Word Reading
• Fluency / Rate and Accuracy
• WIAT-II Reading Fluency
• Reading Comprehension
• WIAT-II Reading Comprehension
• Spelling
• WIAT-II Spelling
• Orthographic Encoding / Decoding -- Phonetic
  Reading Chain Diagnostic Reading Assessment

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Differential Diagnosis

• Good evidence for three forms of disability
• in reading that
• co-occur and
• occur in isolation
• Word recognition
• Comprehension
• Fluency

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Activity 2 CASE STUDIES

• Each Group receives the assessment profile of a
  child.
• Look at the assessment profile and discuss if
  that child could be diagnosed with Dyslexia.
• We do first Case Study together

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SS Standard Scores Distribution

• Very Superior Range gt130 2.2 of Students
• Superior Range 120-130 6.7 of Students
• High Average Range 110-120 16.1. of
  Students
• Average Range 90-110 50. of Students
• Low Average Range 80-90 16.1. of Students
• Borderline Range 70-80 6.7 of
  Students
• Extremely Low lt70 2.2 of Students

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Case Study 1 Rania/ Year 5
WISC-IV Full Scale IQ Average WIAT-II
Listening Comprehension 105 Word
Reading 77 Reading Comprehension 77
Pseudoword Reading 67 Spelling 83
Alphabet No difficulty Consonant
sounds 19/21 Short-vowel sounds 1/5
Dyslexic?
Yes / No
Phonological Awareness 85 Phonological Memory
103 Rapid Naming 91
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Case study Praveen Year 4
WISC-IV FSIQ Average Range WIAT-II Word
Reading 73 Reading Comprehension 98 Listening
Comprehension 104 Pseudoword
Reading 89 Spelling 75
Phonological Awareness 85 Phonological
Memory 97 Rapid Naming 76
Dyslexic?
Yes / No
Alphabet no difficulty Consonant sounds
19/21 Short-vowel sounds 4/5
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Case study Rudy Year 5
WISC-IV FSIQ Low Average Range WIAT-II Listenin
g Comprehension 96 Word Reading 103 Reading
Comprehension 118 Pseudoword Reading 101 Spellin
g 102
Dyslexic?
Phonological Awareness 100 Phonological Memory
88 Rapid Naming 88
Yes / No
Alphabet no difficulty Consonant sounds
20/21 Short-vowel sounds 2/5
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Case study Saloni Year 5
WISC-IV Borderline Range WIAT-II Reading
Comprehension 86 Word Reading 78
Pseudoword Decoding 82 Spelling 80
Alphabet unable to recite or write Naming lower
case letter 25/26 Consonant sounds
18/21 Short-vowel sounds 5/5
Dyslexic?
Yes / No
Phonological Awareness 73 Phonological
Memory 76
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IMPORTANT

• Tests Do Not Evaluate, they give Information
• People Do Evaluate

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4. What to do about it ?

• B Interventions

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Reading Rope
Reading is a multifaceted skill, gradually
acquired over years of instruction and practice.
p. 54
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Principles of Interventions

• Based on thorough Assessment and knowledge of
  learner
• Measurable goals developed after assessment
• Identifies strengths
• Determines the skill deficits to be addressed
• Uses preferred learning modalities
• Active participation of learner
• Strategy based on the above

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Major Intervention Strategies

• A Multisensory Instruction
• B Guided Discovery
• C Mastery Learning

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A Multisensory Teaching

• Uses the Four Pathways of Learning
• Auditory
• Visual
• Kinaesthetic
• Tactile

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Multisensory Teaching

• Simultaneous and alternative deployment of
  visual, auditory, kinaesthetic, and tactile
  sensory modalities that supports the connection
  of oral language with visual language symbols

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Multisensory Teaching

• Example /k/ ck
• Discovering a new letter-sound association by
  listening to words with the same sound in the
  final position while looking at the mouth in a
  mirror feeling how its made, seeing a list of
  the words and writing the new digraph.

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• It is a systematic step-by-step approach,
  proceeding from the simpler to the more complex
  in orderly progression in an upward spiral of
  language development.

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What is Taught?

• Phoneme and Phonological Awareness
• Sound-Symbol Association
• Syllable Instruction
• Morphology
• Syntax
• Semantics

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Using Multisensory Strategies

• Auditory
• Discriminate number of sounds in spoken words
• Say key word and sound
• Segment spoken word into syllables
• Listen for base words, roots and affixes
• Paraphrase sentences accurately

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Using Multisensory Strategies

• VISUAL
• Look at mouth to see mouth position
• Look at card with letter and key word
• Look at printed word to identify vowel sounds
  and number of syllables
• Identify base words, prefixes and suffixes

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Using Multisensory Strategies

• Tactile
• Feel voicing airflow /th/
• Form letters with play dough
• Write in sand tray
• Feel sandpaper letters and words

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Using Multisensory Strategies

• Kinaesthetic
• Arrange letters in alphabetical order
• Use tokens to segment sounds in spoken words
• Feel movement of articulatory muscles
• when phonemes are spoken
• Build words with syllable cards

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LESSON PLAN FORMAT

• Alphabet/Phonemic Awareness
• Letter Sounds Review
• Spelling Sounds
• Discovery of Linguistic Concept
• Handwriting
• Reading Practice
• Spelling Practice
• Review of Todays New Learning
• Extended Reading/Writing
• Listening/Comprehension

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Activity 3 Multisensory teachingTask Teaching
consonant blends

• Demonstration
• Group teaching of blends sl, br, tw and
  sm
• Visual Presenting blend printed on flash card.
• Auditory Say the name of the blend ,say the key
  word of the picture then the sound of the
  blend.
• Student repeats the key word and the sound of the
  blend.
• Teacher says sound and student repeats
• Kinaesthetic Student writes the blend, copying
  from the model, saying name as he/she writes it.
• Student writes it from memory, reads what has
  been written and giving the sound.
• Student writes blend with eyes closed to
  enhance kinesthetic feed back.
• 6. Tactile Form the blend with play dough while
  saying it

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B Guided Discovery

• Guided discovery involves the students pathways
  of learning.
• (Auditory/Visual/Kinaesthetic/Tactile)
• Socratic questioning or guided questioning is
  leading students to the answers without telling
  them.
• Because of the memory systems and the need to
  stimulate multiple modalities, the discovery
  approach to instruction is effective with
  dyslexic students.

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Auditory Discovery

• Uses questioning techniques for auditory
  discovery,
• linking the new to the known, and
• building on similarities or differences.
• What do you hear that is the same?

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Visual Discovery

• After auditory discovery,
• the visual symbols representing the new concept
  or phoneme are presented
• using questioning techniques to lead students to
  self-discovery.
• What do you see that is the same?

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Kinaesthetic / Tactile Discovery

• Skywriting / Walking Shapes/ Play dough creation
  of symbols
• Are some of the techniques used in
  kinaesthetic-tactile discovery
• Make, Trace Copy letter shapes
• Workbook
• Spelling Notebook

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Elements of Discovery Learning
Brain Power
Develops natural curiosity to learn
Links new with old knowledge
Holds interest Active participate responsibility
Develops ability to retrieve information
Discovery Learning
Strengthens knowledge of relationships between
concepts
Develops decision-making skills
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C Mastery Model of Teaching and Learning

• Uses the Following
• Prior Knowledge
• New Learning
• Review
• Practice
• MASTERY

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Mastery Model of
Teaching Learning
ideas
feelings
concepts
Prior Knowledge
memories
Discovery
motivations
experiences
New Learning
cumulative
Review
Practice
Short term memory
automaticity
Mastery 95
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Introduce Review Practice
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Mastery Model Teaching

• Simultaneous Multisensory Instruction
• Guided Discovery
• Intense Instruction/Consistent Practice
• Systematic and Cumulative
• Synthetic and Analytic
• Synthetic how letters come together to
• form a word
• Analytic breaking a word into smaller parts

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• Periodic measures of progress
• Bench Mark Measures determine progress at each
  level of training
• Assures teacher that students knowledge is
  secure before advancing to next level
• Success on each measure serves as motivational
  incentive for student while encouraging
  self-confidence
• New learning based on well-established concepts
  to enable student to integrate skills
  systematically, successfully, and permanently

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• Conclusion
• Effective Scientific Instruction
• individualized
• multidisciplinary
• multisensory
• synthetic-analytic
• Systematic
• Cumulative
• Communicative

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• If instruction is planned to meet the
• differing needs of learners, it is
  individualized.
• If instruction is based on the knowledge
• and skill of experts from many fields,
• including education, psychology, and language
  theory we call it
  multidisciplinary.

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• If the sounds of the letters can be blended into
  words for reading, and the words can be divided
  into the sounds they are made of for spelling and
  writing then we call the process
• synthetic-analytic.
• If instruction simultaneously uses the
• learning pathways of visual (seeing),
• auditory (hearing), and kinaesthetic (movement),
  tactile (touch)
• then it is multisensory.

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• Material is organized and taught in a way that is
  logical and fits the nature of our language. The
  procedure is systematic.
• The learner moves, step by step, in order, from
  simple, well-learned material to that which is
  more and more complex, as he or she masters the
  necessary body of language skills. The teaching
  is sequential.
• Each step of the way is based on those already
  learned. The process is cumulative.

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• The ultimate goal is for a student to understand
  the reasons for what he is learning so that he
  can think his way through language problems. The
  purpose of it all, from recognizing a letter to
  writing a poem, is getting meaning from one
  persons mind to anothers. Communication is
  paramount.

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GOOD NEWS!!!!

• Good news is that students with dyslexia can be
  helped to cope with their difficulties if their
  learning profile is scientifically diagnosed and
  if they are taught on evidence based
  methodologies
• using multisensory teaching methods, within a
  discovery learning framework to mastery level of
  each skill
• they can learn to read and write to a level
  appropriate to their general ability.

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• Perhaps most important of all, with the
  understanding, support, and encouragement of
  parents and teachers they can avoid the hurt and
  burden of failure and frustration that affects
  their lives.