Dyslexia and Phonological...

Dyslexia and Phonological Processing July 2017

DyslexiaandPhonologicalProcessing

RichardWagner,FloridaStateUniversityandtheFloridaCenterforReadingResearch

Dyslexia and Phonological ProcessingSponsored By:

Dyslexia and Phonological Processing – Non Technical Webinar

https://phonologicalprocessing.eventbrite.com

CA Education Code 56334

Dr. Richard Wagner, Ph.D. Biographic Summary

• Robert O. Lawton Distinguished Research Professor of Psychology and the W.

Russell and Eugenia Morcom Chair at Florida State University.

• Co-founder and a current Associate Director of the Florida Center for Reading

Research.

• Ph.D. in cognitive psychology from Yale University in 1985.

• Principal Investigator of a Multidisciplinary Learning Disability Center funded by

the National Institute of Child Health and Human Development (NICHD)

• Co-author of tests that are commonly used in evaluating children for dyslexia and

other learning disability including:

Comprehensive Test of Phonological Processing (CTOPP-2),

Test of Word Reading Efficiency (TOWRE-2),

Test of Preschool Early Literacy (TOPEL).

Overview

• Briefreviewofdyslexia.• Phonologicalprocessinganditsrelationtodyslexia.• HowtousetheCTOPP-2toassessphonologicalprocessing.

• Administrationandscoring.• Interpretingresults.

• Somefrequentlyaskedquestions.

BriefReviewofDyslexia

What“Dyslexic”ReadingLooksLike

• Thehallmarkcharacteristicsoftheword-levelreadingproblemare:• Aninabilitytosoundoutnewwords.

• Newwordsrequiresoundingoutorbyanalogytootherknownwords.• Asmallpoolofwordsreadautomatically.

• Typicalreadersrecognizealargepoolofwordswithlittleconsciouseffort.

LookatButDon’tReadtheFollowingWord

•horseradish

•hovolupshim

PoorSpellingandWriting

• Spellingandwritingmayevenbemoreaffectedthanreadingis.

PoorComprehension

• Readingcomprehensionmaybepoor,butaby-productofnotbeingabletoreadthewordsonthepage.

• Overtime,however,thelimitedinformationcomingthroughthereadingchannelcanalsoaffectcomprehension.

DyslexiaisDimensional

• Continuumexistsfromhavingonlyaminorproblemtoaverysevereproblem.

OriginsofDyslexia

• Majorbreakthroughwasthediscoverythatdyslexiaisduetoaprobleminlanguage notinvision.

OriginsofDyslexia

• Dyslexiarunsinfamilies.• Afamilyhistoryofreadingproblemsisassociatedwitha4timesgreaterriskofdyslexia.

OriginsofDyslexia

• Dyslexiaoccursinbothmalesandfemalesbutmalesareabouttwiceaslikelytohaveasevereproblemthanarefemales.

DyslexiaRarelyOccursAlone

• Co-occurringconditionsaretheruleratherthantheexception.• CommononesincludedADHD,dysgraphia,dyscalculia,poorspellingandwriting,andahistoryofearlyspeechorlanguageproblems.

PhonologicalProcessinganditsRelationtoDyslexia

PhonologicalProcessing

• Phonologicalprocessingreferstousingspeechsoundsforcodinginformationwhenreading,listening,andspeaking.1

• PhonologicalcomesfromtheGreekwordphonewithmeanssoundorvoice.

ThreeKindsofReading-RelatedPhonologicalProcessing2

PhonologicalAwareness

• Awarenessofandaccesstothesoundstructureorphonologyofone’slanguage.

• Howarethespokenwords“cap,”“map,”and“tap,”thesameanddifferentinthesoundstheycontain?

• Identicalmiddleandendingsounds.• Differentbeginningsounds.

• Ifyoucanhearhowtheyarethesameanddifferent,theirspellingsmakesense.

• Differentfirstletter,samemiddleandfinalletters.• cap• map• tap

Development ofPhonologicalAwareness

• Proceedsfromlargerunitstosmaller:• 1.word-length units(e.g.,cow-boy)

• Proceedsfromlargerunitstosmaller:• 1.word-length units(e.g.,cow-boy)• 2.syllableswithinwords(e.g.,sev-en)

• Proceedsfromlargerunitstosmaller:• 1.word-length units(e.g.,cow-boy)• 2.syllableswithinwords(e.g.,sev-en)• 3.onsets(soundpriortovowel)andrimes(vowelandremainingconsonants)withinsyllables(e.g.,frompentop-en)

• 4.phonemeswithinrimes(e.g.fromentoe-n)

• 4.phonemeswithinrimes(e.g.fromentoe-n)• 5.phonemeswithinconsonantclusters(e.g,fromstr tos-t-r).

PhonologicalAwarenessPlaysCausalRoleinLearningtoRead

• Toachildwhocanhearsimilaritiesanddifferencesamong“cap,”“map,”and“tap,”theirspellings(cap,map,tap)aresensible.

• Impairedphonologicalawarenessisacommoncharacteristicofindividualswithdyslexia.

PhonologicalAwarenesscanbeTaught andTrained

• Trainingphonologicalawarenessearlycanpreventoratleastmitigatetheseverityoflaterword-levelreadingproblems.

• Earlyidentificationiscriticaltoprevention.

PhonologicalMemory

• Phonologicalmemoryreferstocodinginformationphonologicallyfortemporarystorageinshort-termmemory.

• Ifyoutrytorememberanumberorsomeone’snameyoujustheardyoumostlikelywillbeusingphonologicalmemory.

• Youdothesameforsoundsthatmakeupthepronunciationofthewordsyouread.

Phonological Memory

• Mostimportantpartofphonologicalmemoryisthephonologicalloop,whichinturncomprisestwoparts:

• 1.phonologicalstore—likeatape-recordingloopthatretainsthemostrecent2secondsofauditoryinformationthathasbeenrecorded.

• 2.articulatorycontrolprocess—providesinputtoandcanrefreshcontentsofphonologicalstore,extendingtimeinformationcanbeheld.

AssessingPhonologicalMemory forEarlyIdentification

• Preschoolagechildrencan’tdophonologicalawareness tasksthatrequireaccesstophonemes(e.g.,say“bat”without/b/),butcandoaversionwithlargerunits.

• Say“starfish.”• Nowsay“starfish”without“star.”• “fish”

CognitiveComplexityStillTooMuchforSomeYoungChildren

• Examiner:“Saydoorbell”

• Examiner:“Saydoorbell”• Child:“doorbell”

• Examiner:“Saydoorbell”• Child:“doorbell”• Examiner:“Nowsaydoorbellwithoutbell”

• Examiner:“Saydoorbell”• Child:“doorbell”• Examiner:“Nowsaydoorbellwithoutbell”• Child:“Doorbellwithoutbell”

PhonologicalMemoryTasksareCognitivelySimple

• Justinvolvesrepeatingwhatyouhear.• Nonwordrepetition, aphonologicalmemorytask,hasbeenusedinchildrenasyoungas2.

OverlapBetweenPhonologicalAwarenessandPhonologicalMemoryforPrereaders

• Beforechildrenlearntoread,phonologicalawarenesstasksandphonologicalmemorytasksareactuallytappingtheidenticalunderlyingphonologicalability.

• Mostlikelyqualityofphonologicalrepresentations.

RapidNaming

• Rapidnamingofdigits,letters,objects,orcolorsrequiresretrievingphonologicalinformation(thepronunciationsoftheirnames)frompermanentmemory.

• Thisretrievalprocessisalsousedwhenretrievingpronunciationsofwordsorpartsofwordswhenyoureadthem.

RapidNaming

• Itmatterswhatyouareaskedtonamerapidly.Oneprimarydistinction:

• Symbolsthatareusedinone’swritingsystemsuchaslettersanddigits.• Non-symbolicitemsthatarenotusedinone’swritingsystemsuchasobjectsorcolors.

Summary

• Dyslexiaresultsfromasubtleprobleminlanguage,notinvision.• Thelanguagesysteminvolvedinthephonologicalsystem.• Threekindsofphonologicalprocessingimportantforreading:phonologicalawareness,phonologicalmemory,andrapidnaming.

AssessingPhonologicalProcessingwiththeCTOPP-22

DifferencesbetweentheCTOPPandCTOPP-2

• 1.Newnorms.• 2.Floorloweredwithadditionofmorebasicitems.Nowgoesdowntoage4.

• 3.Phonemeisolationaddedasnewphonologicalawarenesssubtest.• 4.Addedrapidnamingofdigitsandobjectsto4-6year-oldversion,givingmeasuresofsymbolicandnon-symbolicnaming.

TheThreeKindsofReading-RelatedPhonologicalProcessingareAssessedbytheCTOPP-2

FourPrimaryUsesofCTOPP-2

• 1.Identifyindividualswhoaredeficientinphonologicalprocessing.• 2.Identifyindividualstrengthsandweaknesses.• 3.Evaluateprogressinresponsetoremediationofphonologicalawarenessdeficits

• 4.Asameasureforuseinresearch.

WhoCanAdministertheCTOPP-2?

• Requiresformaltraininginassessment.• Supervisedpracticeintestadministrationishighlydesirable.

• Collegecoursesandworkshopsarewaystoacquiretheseskills.

• Mostexaminershavebackgroundsinschoolpsychology,speechpathology,specialeducation,orarereadingspecialists.

AdministrationGuidelines

• Appropriate forindividuals4-0to24-11inagewhocanunderstanddirections.

• Theentirecorebatterytakesabout30minutestoadminister.

• Subtestsshouldbeadministeredintheordertheyappearintherecordform.

• Ifyouadministerselectedsubtests,dothemintheordertheyappear.

• Twoversionsareprovided,onefor4– 6year-oldsandonefor7—24.

• Ceilingsareprovided.• Ifitemsareaccidentallyadministeredbeyondtheceiling,nocreditisgivenfortheaboveceilingitemsevenifoneormoreisansweredcorrectly.

• Followgoodtestingpractices.SeemanualforsuggestionsspecifictotheCTOPP-2.

MaterialsNeeded

• ExaminerRecordBooklet,PictureBook,CD,deviceforplayingCD,stopwatch,sharpenedpencilwitheraser.

CTOPP-2SubtestsandComposites:4- to6-Year-Old

PhonologicalAwarenessCompositeSubtests(4to6-year-oldversion)

Elision

• Youareaskedtosayawordafterdroppingoutpartofit.Forexample:

• Say“cowboy”withoutsaying“cow”(Correctansweris“boy.”)• Say“grain”withoutsaying“n.”(Correctansweris“gray.”)

Elision

• Nothingneededbeyondrecordform.• Payattentiontowhendirectionsandfeedbackaregiven.• Notethattheprogressionofitemstypesfollowsthedevelopmentalprogressionnotedearlier.

BlendingWords

• Spokenwordsarepresentedinpartsthatmustbeblendedtogethertoformaword.Forexample:

• Youwillhearawordonepartatatime.Listencarefullyandputthesoundstogethertomakeawholeword:/m//oo//s/(“moose”).

BlendingWords

• NeedCoreCD,anddevicetoplaytracks1-33.• Ifchildasksforitemtoberepeated,onerepetitionispermittedperitem.

• Foritems1-12,ifchildsayssoundsseparately(e.g.,“m-e”ratherthan“me,”say“Trytosaythesoundsalltogetherasarealword.”

SoundMatching

• Thetaskistoidentifyawordthatbeginswiththesamesoundasatargetword.Lateritchangestoidentifythewordthatendswiththesamesoundasthetargetword.Forexample:

• Whichwordstartswiththesamesoundas“soap?”“ripe”“toast”or“sand.”(“sand”)

SoundMatching

• Needpicturebook.• Twoparts:firstsoundandlastsound.• Forallitems,pause1secondaftersayingthetargetbeforesayingthe3alternatives.

• Pointtopicturesasnamesarepronounced.• Childmaypointtoorsayanswer.• Itemscanberepeatedonceifchildappearstoforgetnamesgiventopictures.

CTOPP-2SubtestsandComposites:7- to24-Year-Old

PhonemeIsolation

• Thetaskistosayapartofawordthatrepresentsthe1st,2nd,3rd,or4th soundinaword.Forexample:

• Whatisthesecondsoundintheword“witch?”(correctansweris/i/).

PhonemeIsolation

• Nothingneededbeyondrecordform.• Payattentiontowhendirectionsandfeedbackaregiven.

AlternatePhonologicalAwarenessCompositeScore

• Forchildrenandadultsage7through24only.• ItconsistsofBlendingNonwords andSegmentingNonwords andcanbeusedtoverifyaprobleminphonologicalawareness.

BlendingNonwords

• NeedSupplementalSubtestCDtracks1-31.• Youmayreplayanitemonetimeifexamineeasksyoutoorgivesnoresponse.

• Foritems1-12,giveprompt“Trytosaythesoundsalltogether”ifexamineerepeatssoundsseparately.

SegmentingNonwords

• NeedSupplementalSubtestCDtracks32-64.• Repeatanitemiftheexamineemispronouncesawordoraskstohearitagain.

• Promptwith“Nowsay____onesoundatatime”iftheexamineeforgetsto.

PhonologicalMemoryCompositeScore

• Forallchildrenandadults,thephonologicalmemorycompositescoreconsistsofMemoryforDigitsandNonword Repetition.

MemoryforDigits

• Thetaskistolistentoastringofdigitsthenrepeatthembackinthecorrectorder.Forexample:

• “3859472”

MemoryforDigits

• NeedCoreCD,anddevicetoplaytracks34-63.• Ifchildasksforitemtoberepeated,norepetitionispermitted.• Foritems1-4,ifchildmakesanerror,countitemasincorrectbutgivecorrectanswer.

Nonword Repetition

• Thetaskistolistentononwords andsaythemexactlyastheyareheard.Forexample:

• Listentothismade-upwordthensayitexactlyasyouhearit:“vootusoaf.”

Nonword Repetition

• NeedCoreCD,anddevicetoplaytracks64-96.• Ifchildasksforitemtoberepeated,norepetitionispermitted.• Payattentiontofeedbackgivenonitems1– 9.

RapidNamingCompositeScores

• Forchildrenage4to6,therearetworapidnamingcompositescores:• RapidSymbolicNaming• RapidNon-SymbolicNaming

• Forchildrenandadultsage7to24,theonlyrapidnamingcompositescoreisRapidSymbolicNaming.

RapidSymbolicNaming

• RapidLetterNamingrequiresletterspresentedinrowsasquicklyandaccuratelyasonecan.RapidDigitNamingissimilarexceptthatdigitsratherthanlettersarenamed.

RapidDigitandRapidLetterNaming

• NeedstopwatchandPictureBooklet.• Recordnumberofsecondstonameallnumbersonform.• Ifexamineehesitatesfor2seconds,markitasincorrectandpointtonextitemandsaygoon.

• Iflineisskipped,redirectexamineetoskippedline.

RapidNon-SymbolicNaming

• RapidColorNamingrequiresnamingcolorsasquicklyandaccuratelyasonecan.RapidObjectNamingisthesamebutcommonobjectsarenamedinsteadofcolors.

RapidColorNamingandRapidObjectNaming

• NeedstopwatchandPictureBook• Promptexamineewiththenextitemifheorshehesitatesformorethan2seconds.

• Iflineisskipped,redirecttoskippedline.

ComprehensiveTestofPhonologicalProcessing-2

ScoringandInterpretation

TypesofScores

• Rawscores—scoresearnedonthesubtests.• Ageequivalents—identifiesageatwhichperformancewouldbeaverage.

• Gradeequivalents—identifiesgradeatwhichperformancewouldbeaverage.

• Ageandgradeequivalentsarenotrecommendedforusebecauseofcommonmisinterpretations.

TypesofScores

•Percentileranks—indicatesthepercentageofthenormativedistributionthatscoredatorbelowtheexaminee’sscore.

•Subtestscaledscores—standardscorewithameanof10andastandarddeviationof3.

•Compositescores—standardscoreswithameanof100andastandarddeviationof15.

TypesofScores

• Developmentalscore—anequalintervaldevelopmentalscaleusefulforexaminingabsolutechangesinperformanceovertime.

• Whatthismeansisthatthedifferencebetween50and100isexactlythesameasthedifferencebetween100and150.

• Thismakesthedevelopmentalscoreusefulformonitoringprogressinresponsetointervention(RTI).

SomeGeneralRecommendations

•Compositescoresarepreferredoversubtestscoresbecausetheyaremorereliable.TheyarethemostusefulscoresontheCTOPP-2.

•Forsubtests,standardscoresareusedtocompareascoretothenormativesample;developmentalscoresareusedtomeasurechangeinabsoluteperformance.

CompositesScores

•Compositescoresareavailableforeachofthethreekindsofreading-relatedphonologicalprocesses.

• PhonologicalAwareness(andAlternatePhonologicalAwarenessforthe7-to-24ageform),PhonologicalMemory&RapidNaming

• Theyarecombinationsofindividualsubtests.

InterpretingCompositesScores

• 130+ VerySuperior• 121-130 Superior• 111-120 AboveAverage• 90-110 Average• 80-89 BelowAverage• 70-79 Poor• 70- VeryPoor

SubtestScaledScores

• Astandardscorethatisidenticalforeachsubtestmakingitpossibletocompareperformanceacrossdifferentsubtests.

• Theaveragesubtestscaledscoreis10.

InterpretingSubtestScaledScores

• 17-20 VerySuperior• 15-16 Superior• 13-14 AboveAverage• 8-12 Average• 6-7 BelowAverage• 4-5 Poor• 1-3 VeryPoor

IdentifyingInformationSection

ScoreReportingSection

ScoreInterpretation:RawScores

• Howmanyitemswerecorrectforeachsubtest.

• Notverymeaningfulforcomparingsubtestsbecausetheyhavedifferentnumbersofitems.

AgeandGradeEquivalents

• Thesearetheageandgradethatthescorewouldbeaveragefor.

• Asmentionedpreviously,theyareeasilymisinterpreted.Bestnottousethem.

ScaledScores

• Thesearethebestscorestocompareperformanceondifferentsubtests.

PercentileRanks

• %ile RanksshowthatJoshua’sscoresareonlybetterthanorequaltothebottom8to21percentofhispeers.

CompositeScores

• Thecompositescoresandtheirdescriptivetermsfollow.

• Joshuaisbelowaverageorpoorineveryareaofphonologicalprocessing.

CompositeScoreDiscrepancyAnalyses

• Aretwocompositescoresdifferentstatistically?

• Aretwocompositescoresdifferentclinically?

StatisticallySignificantDiscrepancies2

ClinicallySignificantDiscrepancies(4-6-year-old)2

ClinicallySignificantDiscrepancies(7-24-year-old)2

FrequentlyAskedQuestions

• WhenshouldIgivethesupplementalsubtests?• Toconfirmthepresenceofaphonologicalprocessingdeficit.• Especiallyusefulforexamineeswithwell-developedvocabularieswhoseperformanceonword-basedphonologicalawarenesstasksmaybeinflatedbytheirvocabulary.

• CanIdiagnosedyslexiafromtheCTOPP-2alone?• Nosingleassessmentcandothis.

• TheCTOPP-2isusedtoassessphonologicalprocessing.• Adeficitinphonologicalprocessingisahallmarkofdyslexia,butisnotsufficientbyitself.

• CanIdiagnosedyslexiafromtheCTOPP-2alone?(cont.)• Otherthingsareimportanttoassess:

• Unexpectedlypoorreading,familyhistory,poorresponsetoeffectiveintervention,andexclusionarycriteria(e.g.,missedvisualacuityproblem,limitedopportunitytolearnbecauseofextensiveabsences).

• Isadeficitinanyofthe3composites(PhonologicalAwareness,PhonologicalMemory,andRapidNaming)apotentialcauseofdyslexia?

• Yes.Eachofthethreekindsofphonologicalprocessingisrelatedtoandimportantforreading.

• CananindividualhavedyslexiaandnotscorepoorlyontheCTOPP-2?• Yes,especiallyifalotofinterventiononphonologicalprocessinghasbeengiven.

• Thisismorecommonforphonologicalawarenessthanforphonologicalmemoryorrapidnaming,andmorecommonforindividualsubteststhanforcompositescores.

• Whatis“double-deficit”dyslexia?• Itreferstobeingbelowaverageinboththephonologicalawarenessandrapidnamingcompositescores.(Whetheritisaseparateconditionorjustanindicationofverylowphonologicalprocessingisamatterofcontroversy.)

• IfanindividualscoresintheaveragerangeontheCTOPP-2butwellaboveaverageinIQorlanguagemeasures,wouldthisbeanindicationofaphonologicalprocessingproblem.

• Yesbecausephonologicalprocessingisimpairedrelativetoperformanceinotherareas.

• CanpoorperformanceontheCTOPP-2beduetoinattentionandnotpoorphonologicalprocessing?

• Probablynot.Problemsinattentionandinphonologicalprocessingcommonlyco-occur,andbotharepredictorsofdyslexia.InattentiondoesnotexplainpoorperformanceontheCTOPP-2formostindividuals.

• Whatifthereislargerangebetweenthesubtestscoreswithinagivencompositescore?Wouldthatindicatetheneedforfurtherassessment?

• Itwouldsuggesttheneedforfurtherassessment.Perhapsthestudentdidnotunderstandoneofthetasks.

• Canachildhavealanguagedisordersuchasspecificlanguageimpairmentanddyslexia?Ifso,whatwouldthatlooklike?

• Yes.Whatyouwouldexpecttoseeisanimpairmentinphonologicalprocessingandinreadingthatisgreaterthanthemagnitudeofthespecificlanguageimpairment.

• CantheCTOPP-2beusedtomeasureresponsetointervention?• Thedevelopmentalscoresprovideanequalintervalscalethatisusefulformeasuringlonger-termresponsetointervention.

• Longer-termbecausetheCTOPP-2shouldnotbegivenmorefrequentlythanannuallytoavoidpracticeeffects.

• DoesnotusingtheaudioCDvalidatetheadministrationoftheCTOPP-2?

• TheaudioCDshouldbeusedforseveralreasons.• Itprovidesastandardizedassessment.• Itwasusedforthenormativesample.• Verballypresentingtheitemsgivesexamineeswhowatchanexaminer’smouthcluesthatwerenotavailabletothenormativesample.

• Whichcompositesshouldimprovewithintervention?• Interventionismoresuccessfulfordeficitsinphonologicalawarenessthanforphonologicalmemoryorrapidnaming.

HaveaQuestionyouNeedAnswered?

• rkwagner@psy.fsu.edu

References• 1 Wagner,R.K.,&Torgesen,J.K.(1987).Thenatureofphonologicalprocessinganditscausalrelationswithreading.PsychologicalBulletin,101,192-212.

• 2Wagner,R.K.,Torgesen,J.K.,Rashotte,C.A.,&Pearson,N.A.(2013).ComprehensiveTestofPhonologicalProcessing (2nd ed.).Austin,TX:Pro-Ed.

Thank you to our Presenter and Sponsors

Florida Center for Reading Research - www.fcrr.org

Florida State University - www.fsu.edu

Decoding Dyslexia CA www.decodingdyslexiaca.org

CA Association of School Psychologists www.casponline.org

CARS+ www.carsplus.org

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