Assessment for Differential Diagnosis of Learning Problems and Intervention Dawn P. Flanagan, Ph.D....

Assessment for Differential Diagnosis of Learning Problems and Intervention

Dawn P. Flanagan, Ph.D.

St. John’s University

Yale Child Study Center, School of Medicine

Relations between cognitive constructs and academic areas

Summary of Relations between CHC Abilities and Specific Areas of Academic Achievement (Flanagan, Ortiz, Alfonso, &

Mascolo, 2006)

CHC Ability

Reading Achievement

Math Achievement

Writing Achievement

Gf Inductive (I) and general sequential reasoning (RG) abilities play a moderate role in reading comprehension.

Inductive (I) and general sequential (RG) reasoning abilities are consistently very important at all ages.

Inductive (I) and general sequential reasoning abilities is related to basic writing skills primarily during the elementary school years (e.g., 6 to 13) and consistently related to written expression at all ages.

Gc Language development (LD), lexical knowledge (VL), and listening ability (LS) are important at all ages. These abilities become increasingly more important with age.

Language development (LD), lexical knowledge (VL), and listening abilities (LS) are important at all ages. These abilities become increasingly more important with age.

Language development (LD), lexical knowledge (VL), and general information (K0) are important primarily after age 7. These abilities become increasingly more important with age.

Gsm Memory span (MS) is important especially when evaluated within the context of working memory.

Memory span (MS) is important especially when evaluated within the context of working memory.

Memory span (MS) is important to writing, especially spelling skills whereas working memory has shown relations with advanced writing skills (e.g., written expression).

Gv Orthographic Processing May be important primarily for higher level or advanced mathematics (e.g., geometry, calculus).

Ga Phonetic coding (PC) or “phonological awareness/processing” is very important during the elementary school years.

Phonetic coding (PC) or “phonological awareness/processing” is very important during the elementary school years for both basic writing skills and written expression (primarily before age 11).

Glr Naming facility (NA) or “rapid automatic naming” is very important during the elementary school years. Associative memory (MA) may be somewhat important at select ages (e.g., age 6).

Naming Facility (NA); Associative Memory (MA) Naming facility (NA) or “rapid automatic naming” has demonstrated relations with written expression, primarily the fluency aspect of writing.

Gs Perceptual speed (P) abilities are important during all school years, particularly the elementary school years.

Perceptual speed (P) abilities are important during all school years, particularly the elementary school years.

Perceptual speed (P) abilities are important during all school years for basic writing and related to all ages for written expression.

See McGrew and Wendling (2010) for an extension of this work

Relations between CHC Abilities and Processes and Reading Achievement

Gf – Induction (I) and general sequential reasoning (RG) play a moderate role in reading comprehension

Gc – Language development (LD, lexical knowledge (VL), and listing ability (LS) are important at all ages. These abilities become increasingly more important with age

Gsm – Memory span (MS) is important, especially when evaluated within the context of working memory

Gv – Orthographic processing


Ga – Phonetic Coding (PC) or phonological awareness; phonological processing – very important during the elementary school years.

Glr – Naming facility (NA) or “rapid automatic naming” is very important during the elementary school years. Associative memory (MA) may be important at early elementary school ages.

Gs – Perceptual speed (P) abilities are important during all school years, particularly the elementary school years.


Gf – Induction (I) and general sequential reasoning (RG) play a moderate role in reading comprehension

Gc – Language development (LD, lexical knowledge (VL), and listing ability (LS) are important at all ages. These abilities become increasingly more important with age

Gsm – Memory span (MS) is important, especially when evaluated within the context of working memory

Gv – Orthographic processing


Ga – Phonetic Coding (PC) or phonological awareness; phonological processing – very important during the elementary school years.

Glr – Naming facility (NA) or “rapid automatic naming” is very important during the elementary school years. Associative memory (MA) may be important at early elementary school ages.

Gs – Perceptual speed (P) abilities are important during all school years, particularly the elementary school years.

Building on the work of Flanagan and Colleagues (2006)

McGrew and Wendling (2010) Need to move from general to specific

Reading -> basic reading skills; reading comprehension Math -> basic math skills; math application

Need to systematically take into account developmental level Ages 6-8 years Ages 9-13 years Ages 14-19 years

Need to control for specification error Seems necessary primarily if interested in percentage of

variance accounted for in academic outcome May pose more of a limitation (e.g., Flanagan et al. had

over 100 studies in their review; McGrew and Wendling had less than 20)

Comparison tables may be found in: Flanagan & Alfonso (2011). Essentials of Specific Learning Disability Identification. Hoboken, NJ: Wiley.

Comparison tables may be found in: Flanagan & Alfonso (Eds.) (2011). Essentials of Specific Learning Disability Identification. Hoboken, NJ: Wiley.

Cognitive Correlates and Diagnostic Markers for SLD in Oral Language

(Receptive and Expressive) Attention Processing Speed Short-term Memory (particularly Working

Memory) Word Retrieval (Glr)

Basic Reading Skills – ages 6 to 8 – WISC-IVSlide Adapted from Kevin S. McGrew

Broad DomainMarkers

GcCrystallized Intelligence

GsmShort-TermMemory

Ga AuditoryProcessing

Gs ProcessingSpeed

Glr Long-TermRetrieval

Snd. Aware (PC/MW) Snd. Blending (PC)

Vis.-Aud.-Lrng. (MA) Rapid. Pic. Nam. (NA) Retrieval Fluency (FI) (NA)

Narrow DomainMarkers

Work Mem (MW)

Lang. Dev. (LD)Listen. Ability (LS)Gen. Info. (K0)Lex. Know. (VL)

Phonetic Coding (PC)

Perc. Speed (P)

Assoc. Mem. (MA)Naming Fac. (NA)

Relevant WISC-IV tests

XBA Supplemental Tests from WJ III

Digit Span (MS/MW)Letter-Number Seq. (MW)

Coding (P/R9)Symbol Search (P)Cancellation (P)

Vocabulary (VL)Similarities (LD/VL)Comprehension (LD)Information (K0)Word Reasoning (LD/VL)

We Have Knowledge of What Our Tests Measure According to CHC Theory

We Have Knowledge of What Cognitive Constructs are Most Closely Related to

Academic Achievement

Cross-Battery Assessment Approach Classification system Joint or CB-FAs Content Validity/Expert

Consensus Facilitated the use of a

common nomenclature

Beginning to link CHC and neuropsychological theory and research

What is the School Psychologist’s Goal When Working With Students With

Significant Learning Difficulties and Skill Deficiencies?

Identify targets for remediation and determine what the student needs to improve academically

RTI at Tiers I and II

Mascolo and Flanagan (2010)

Tier I Screening At-risk in Reading

Decoding Fluency Comprehension

Tier II Treatment Protocol Reading Recovery

•StudentsAmyBelindaCarl

Reading Recovery Results Amy, Belinda, and Carl

are making some gains in Reading Recovery

No appreciable change in reading performance

Tier II “nonresponders”

CHOICE move to Tier III or conduct a “diagnostic

assessment”


INDIVIDUAL DIFFERENCES ARE IMPORTANTOne Size Does Not Fit All

Different Cognitive Ability Profiles Suggest Different Interventions

Amy’s cognitive testing shows a significant deficit in phonetic coding – she doesn’t know how to translate symbols into sounds

Ga deficit impacts her fluency – labored reading Lack of decoding and fluency impacts comprehension Intervention should focus on Phonemic Awareness – Remediate

Ga

Different Cognitive Profiles Suggest Different Interventions


Gc deficit – speech-language impairment? Comprehension is poor b/c of low Gc Poor vocabulary – needs to re-read to gain meaning, which impacts

fluency Intervention should focus on vocabulary development – Build Gc-VL, KO

– and building fluency Accommodation of extended time may be warranted due to a Gs deficit



Gsm deficit – memory span and working memory are deficient; visual memory ok Decoding is poor – he cannot hold the complete phonemic string in mind long

enough to say the word Comprehension is poor because he needs to allocate all memory space decoding

words and therefore cannot focus on meaning Fluency is impaired because he must re-read the text to gain meaning Intervention should focus on developing a sight word vocabulary Carl needs to be taught compensatory strategies to assist with poor Gsm (text

previews; guided notes; one comprehension question at a time)



Different Cognitive Ability Profiles Suggest Different Interventions

All had same academic deficits

(decoding, comprehension, fluency)

All made slow gains with

Reading Recovery

All had different patterns of cognitive

strengths and weaknesses

Reading Recovery – allocating time

to areas that do not need to be

trained

Not enough explicit instruction in

main problem area because the

intervention was not tailored


Amy’s Intervention

No need to focus on comprehension and fluency Amy needs phonemic awareness training


Programs/Techniques for Ga-Phonetic Coding Deficits

When selecting a program or a technique to intervene with a student with a Ga deficit, consider one that Teaches students to manipulate sounds by

using letters (i.e., phoneme-grapheme correspondence)

Uses individual or small group format Focuses on reading and spelling development

(again, the phoneme-grapheme connection) Explicitly teaches student how to blend

sounds

Another Program for Ga-Phonetic Coding Deficit

Road to the Code

Provides 44 lesson plans that include games to encourage phonemic awareness. The games are

Say-It-and-Move-It—the child learns to recognize phonemes by moving a disk for every phoneme heard

Letter Name and Sound Instruction—the child learns the name of the letter that produces the phoneme heard and what the letter looks like

Phonological Awareness Practice—the child participates in a range of simple phonological awareness tasks.

Belinda’s Intervention

No need to focus on decoding Belinda needs to focus on building her vocabulary She will also benefit from interventions designed

to build fluency


Recommendations for Gc Deficit

Work on vocabulary building Teach morphology Activities to build listening skills Explicitly teach listening strategies Use text talks

http://teacher.scholastic.com/products/texttalk/overview/readaloud.htm



Belinda also has a Gs Deficit – Suggest Need to Work on Building Fluency

Choral Repeated Reading Students listen to the text being read and

follow along by reading aloud and looking at the text (using their fingers to keep pace)

10 to 15 minutes Text can be higher than students’

instructional level Comprehension activities can be added Feedback and assistance can be provided

Carl’s Intervention

No need to focus on comprehension or fluency Carl needs sight word reading and memory

strategies


Build Sight Words

Go to: http://www.mrsperkins.com/dolch.htm

Print Flash Cards

Use folding-in technique (builds confidence)

http://www.mrsperkins.com/dolch.htm

Increase Vocabulary

UNDERSTANDING A STUDENT’S PATTERN OF (COGNITIVE AND ACADEMIC) STRENGTHS AND

WEAKNESSES INFORMS INTERVENTION

REMEMBER: ECOLOGICAL VALIDITY IS

ESSENTIAL

Manifestations of Cognitive Weaknesses and Examples of Recommendations and Interventions (Flanagan, Alfonso, & Mascolo, 2011, in press)

Flanagan, D. P., Alfonso, V. C., Sotelo-Dynega, M., & Mascolo, J. T. (in press). Use of Ability Tests in the Identification of Specific Learning Disabilities (SLD) within the context of an Operational Definition. In D.P. Flanagan & P.L. Harrison, Contemporary intellectual assessment: Theories, tests, and issues (3rd edition). New York: Guilford. Flanagan, D. P., Alfonso, V. C., & Mascolo, J. T. (2011). A CHC-based Operational Definition of SLD: Integrating Multiple Data Sources and Multiple Data Gathering Methods. In Flanagan, D. P., & Alfonso, V. C. (Eds.), Essentials of Specific Learning Disability Identification. New York, NY: John Wiley & Sons.

What Do You RECOMMEND When You Only Have Progress

Monitoring Data?

Student: Willie

Age: 11

Grade: 3

Retained: 1st and 3rd grades

20 Pages of RTI Data

2 Pages of

History/Background

Grade RLI LNF ISF PSF NWF DORF MISC

KG (05-06) S 19 AA 0

Age 6 S 13 MR 18

iii 18 HR 14 MR 0 2

S 29 MR 4 HR 15 MR

PPVT 85

1st (06-07) ii 43 LR 53 AA 28 LR 0

Age 7 iii 76 AA 25 HR 2

ii 68 AA 40 MR 10 HR

PPVT 92

Stanford-10 15%

1st (07-08) ii 68 AA 39 LR 29 LR 6 MR

Age 8 S 36 LR 42 MR 17 MR

iii 30 MR 25 HR 18 HR

PPVT 89

Stanford-10 20%

2nd (08-09) iii 19 HR 21 HR

Age 9 iii 22 HR 36 HR

iii 26 HR 46 HR

PPVT 94

Stanford-10 8%

Student: Willie; Course of Action: “Tier 1 and Tier 2 Student Who is on his way to Tier 3”

REGARDLESS OF TREATMENT

PROTOCOL, YOU MUST STAY AT

LEARNING LEVEL UNTIL MASTERY

Automaticity

Process of going from explicit to implicit memory

Efficient way of managing overwhelming amounts of information

Implicit memory-laying down of skills and habits that, once learned, do not have to be consciously thought about – eating, talking, walking, reading

Information on this slide was presented by Elaine Fletcher-Janzen at the 3rd annual assessment conference, Fordham University. New York, NY (May, 2011).

What Does it Look Like?

Pathology Labored reading Tires easily Faltering at math

facts and subsequent math problems

Does Willie demonstrate any of these characteristics?

Wellness Quick reader with

prosody Instant math facts Takes to new math

problems consistently


What do we Do?

Check to see if skill deficit is more of a lack of automaticity than ability This distinction is

not clear based on the information provided for Willie

Break down content and slowly build up to complex skills

Move from one level to another after mastery is fluid and automatic

Keep instruction simple and rote

Stay at learning level until mastery


Assessment Grade 3:Reading Comprehension

FACT Success Probability Maze Word Analysis

2009-2010

1 2% 5% 2%

2 2% 23% 1%

3 5% 1% 2%

2010-2011

1 4% 15% 22%

Date Oral Reading Fluency - WCPM

9-30-10 97

10-12-10 129

10-26-10 115

Average WCPM 113

3rd GradeOPM – at benchma

rk for early 3rd grade

Did Willie Stay at Learning Level Until Mastery?

OPM within and across grades often yield inconsistent results; difficult to interpret

Willie: Problem with RTI Data Presentation

RTI data not explained; not placed in context

RTI data not explained within the context of classroom performance, standardized test performance, etc.

RTI/data collection continued for too long…several years before considering SLD (other conditions) and special education eligibility

Example: Not Enough Data Reported from RTI

Alan; 3rd grade; repeated 1st grade; age 10 From Report: “Response to Intervention Data”

“Alan has been receiving intensive Tier 3 interventions through the School-based Intervention Team since early Fall to address reading and communication concerns. Response to intervention data indicate that Alan has not shown adequate growth.”

WHAT I DON’T KNOW When intervention began Type of intervention Who delivered intervention Attendance during intervention Integrity of intervention delivery Whether or not the intervention was matched to child’s

instructional level Whether or not the intervention was selected based on student’s

demonstrated deficits in academic areas (vs. standard treatment protocol)

Other Issues with RTI Data in Psych Reports

Progress monitoring data not reported/explained in psychological report

Inconsistencies in progress monitoring data not explained

Progress monitoring data not integrated with other data sources

See case of Johnny

Progress Monitoring Results for Johnny

Letter Naming Fluency – one minute probe; KS score likely spurious due to unreliability of the measure (or some other factor); he knows his letters (see KTEA-II Letter-Word Identification) and has demonstrated that he can name them quickly

KTEA-II Letter & Word Recognition

Recognizes all letters

Demonstrated in K that he can say the letters quickly

KS LNF score is not indicative of true performance

Progress Monitoring Results

Letter Sound Fluency – OKPhoneme Segmentation Fluency – OK (segment 3 to 4 phoneme words into individual phonemes in one minute)Nonsense Word Fluency – perhaps a different evaluator (at KS and 1F). KS performance is unlikely because Johnny cannot read (see Nonsense Word Decoding on KTEA-II)

KTEA-II Nonsense Word Decoding performance is consistent with 1F NWF

Both performances call into question the KS NWF performance

Reading - CBM

Assessed Johnny’s accuracy and speed of reading grade level text

Was accuracy impacted by his articulation difficulties? He substitutes “d” for “g”, “w” for “l” (wov instead of love), “bw for bl”, “fw for fl”, “gw for gl” (gwass instead of glass), “pw for kl”, “pw for pi”, “sw for sl”, “f for th”, and “d for th”.

Johnny’s R-CBM is consistent with his performance on the KTEA-II Letter & Word

Recognition Test

Ehri’s Phases of Word Reading

Pre-Alphabetic (e.g., when a child says “that says stop!” when they see a red octagonal traffic sign, but cannot read the word “stop” in isolation)

Partial-Alphabetic Understand that there is a relationship between letters

and sounds Rely on beginning and ending sounds so they continue

to make errors in reading words (e.g., reading “bank” as “book” or “bake” or “belt”)

Ehri’s Phases of Word Reading

Fully Alphabetic Phase – students are able to sound out words successfully They know the sound-symbol connections and move from

guessing a word from the first or last letter to complete word decoding sound by sound. (e.g., /b/ /a/ /n/ /k/)

When they see the same word more than a few times, then that word becomes automatically recognized.

As more and more words become “sight” words, students move into the consolidated alphabetic phase (e.g., /b/ /ank/)

There is an assumption that Johnny is AT the fully alphabetic phase. He is not. Therefore, developing this phase of reading should be the immediate goal for reading intervention.

Summary of Classroom Observation

Johnny was observed in his first grade classroom by the Speech Language Pathologist

During the observation, students were working in their journals independently and participating in Calendar Math, weather review, and a movement/music activity.

Johnny had a hard time getting started on his writing assignment independently. When his teacher prompted him, he said he didn’t know what to write about.

Johnny “didn’t know what to write about”

Fan, dog, he, book Can Johnny work in

his journal independently?

Johnny doesn’t have the skills to write in a journal

Summary of Classroom Observation

The observer also prompted him by encouraging him to draw pictures about their upcoming field trip to a dairy farm and she gave him several examples of what he might draw. When she asked him what he was going to draw, he stated that he was going to draw a “monster truck” and “hot lava.” Johnny wrote several letters on his paper and began copying another student’s name from the wall.

Johnny wants to Write But he Doesn’t Have the Skills

He is at this level

“I Miss Home”


He is at the partial alphabetic stage and cannot write words or sentences…

It is a good idea to ask the child what he/she wrote (random letters? Or does what he said he wrote make sense within the context of the tasks?


Recommendation in report: “Johnny should work on improving his reading

accuracy and reading speed”

Teach Phonological Awareness – Move from Partial Alphabetic Phase to Fully

Alphabetic Phase

Go To ReadingRockets.org

Build Sight Words

Go to: http://www.mrsperkins.com/dolch.htm

Print Flash Cards

http://www.mrsperkins.com/dolch.htm

Adapt Writing Assignments

Have Johnny tell you what he wants to write about

Provide structure based on instructional level. For example, Johnny wants to write about monster trucks. __onster ___rucks are bi___. I have a re__

Monste__ Truc__. Task: Fill in missing letters. Re-write first sentence.

This will keep Johnny busy during journal time with a journal activity that is at his instructional level.

Subject 2006 2007 2008 2009 2010 2011

Kindergarten(age 6)

1st

(age 7)1st (Retained) 2nd

(age 9)3rd

(age 10)3rd

(age 11)

LangDevlp N F C F D D

Reading N F C C D C

Handwrtn N

Math N F B C F C

Science S D B B C C

Social Sts N D B C C D

Art S A A A B B

Music S A A A B B

Phys Ed S A A A A A

FCAT Reading 20% 8%

FCAT Math 17% 4%

Student: Willie; Course of Action: “Tier 1 and Tier 2 Student Who is on his way to Tier 3”

A MAJOR INHIBITING FACTOR TO LEARNING AND ACHIEVEMENT IS

RETENTION

Retention: Just the Facts Academic achievement of kids

who are retained is poorer than that of peers who are promoted.

Achievement gains associated with retention fade within two to three years after the grade repeated.

Kids who are identified as most behind are the ones "most likely harmed by retention."

Retention often is associated with increased behavior problems.

National Association of School Psychologists

Retention: Just the Facts Grade retention has a negative

impact on all areas of a child's achievement (reading, math, and language) and socio-emotional adjustment (peer relationships, self-esteem, problem behaviors and attendance).

Students who are retained are more likely to drop out of school compared to students who were never retained. In fact, grade retention is one of the most powerful predictors of high school dropout.

National Association of School Psychologists

Retention: Just the Facts

Retained students are more likely to have poorer educational and employment outcomes during late adolescence and early adulthood.

Retention is more likely to have benign or positive impact when students are not simply held back, but receive specific remediation to address skill and/or behavioral problems and promote achievement and social skills.National Association of School Psychologists

Progress Monitoring and SLD Identification

(slide adapted from Dan Miller)

Multiple Reading Interventions tried with Willie

Willie Remains Moderate to High Risk After Several Years of Intervention

PM data alone will lead to SLD by default

What about other causal factors, such as: • Other disabilities (e.g., intellectual disability)• Cultural or language difference• Psychological factors• Poor treatment fidelity • Inappropriate intervention based on child’s

cognitive strengths and weaknesses• Significant behavioral or social-emotional issues

Progress Monitoring data alone do not answer the question of why the child is significantly behind same age

and grade peers

Why Is the “Why” in Cases of Suspected SLD Important?

Differential diagnosis Psychological health of the student Expectations Treatment/Intervention

FACILITATORS TO LEARNING INHIBITORS TO LEARNING

He is praised, encouraged, and rewarded for good behavior at home

He is violent/aggressive (rolls up and down hall when things do not go his way; cannot control his temper; tried to kill a puppy)

Mother came to the school and asked for help. She reported that “nothing seems to be working.”

Parent Unemployed; Food Stamps; Low SES; parents divorced

Good attendance Not toilet trained (cannot control his bowels; has accidents); Encopresis

Family history of Learning Disability (Grandmother, aunts, cousins, and sister have learning disabilities)

Behavioral difficulties at home (parent cannot control his behavior; constantly fighting; lacks respect; curses at grandmother; fights with siblings)

Poor peer relationships; always fighting

Delayed Language (first words at age 2; first phrases in 1st grade)Serious family illness (Grandmother very sick and is bed bound)

Parents have H.S. education or less (mother completed 11th grade; father graduated from H.S.)

Has poor self-esteem

Information About Willie Collected via Parent Interview

RTI-ONLY (PROGRESS MONITORING ONLY) APPROACHES

“Slow reading acquisition has cognitive, behavioral, and motivational consequences that slow the development of other cognitive skills and inhibit performance on many academic tasks. For example, knowledge bases that are in reciprocal relationships with reading are inhibited from further development. The longer this developmental sequence is allowed to continue, the more generalized the deficits will become, seeping into more and more areas of cognition and behavior. Or to put it more simply and sadly—in the words of a tearful 9-year-old, already falling frustratingly behind his peers in reading progress, ‘Reading affects everything you do.’ ” (p. 390)

Are We On The Right Track With RTI?

Stanovich, K. E. (1986). Matthew effects in reading: Some consequences of individual differences in the acquisition of literacy. Reading Research Quarterly, 21, 360-407.

What We Know There are many approaches and methods

that aid in understanding, identifying, and treating SLD RTI Ability-Achievement Discrepancy Third Method Approaches (“Pattern of Strengths

and Weaknesses”) Demand Analysis/Process Approach - School

Neuropsychololgy There is no litmus test; the more well-versed

you are in different approaches and methods, the more information you will gain about the child (including how to best help him or her)

Third Method Approaches

Multiple Methods/Multiple Data Sources

for SLD Identification

COGNITIVE STRENGTH/INTEGRI

TY Average or higher abilities and processes; May also include strengths in

academic skills

ACADEMIC WEAKNESS/FAILU

RE

Academic Skills/Knowledge

Deficits

COGNITIVE WEAKNESS/DEFI

CIT

Cognitive Ability or Processing Disorder

Statistically significant difference between cognitive integrities and circumscribed cognitive ability or

processing deficit(s)

Cognitive deficit(s) is specific, not general or pervasive, because

overall cognitive ability is at least average

No Statistically significant Performance Difference (constructs are related

empirically )

Statistically significant difference between cognitive integrities and

academic skill deficit(s)

Academic deficit(s) is unexpected, not expected,

because overall cognitive ability is at least average

Consistent/Concordant

Dis

crep

ant/D

isco

rdan

t Discrepant/D

iscordant

Sotelo, Flanagan, and Alfonso (2011). Overview of SLD Identification. In D. P. Flanagan & V. C. Alfonso, Essentials of Specific Learning Disability Identification. Hoboken, NJ: Wiley. Flanagan, Fiorello, and Ortiz (2010); Hale, Flanagan, and Naglieri (2008)

Common Elements of “PSW Component” of Third Method Approaches to SLD Identification

Fuchs and Young (2006). On the irrelevance of intelligence in predicting responsiveness to reading instruction, 73(1), pp. 8-30.

Better Title: On the RELEVANCE of Intelligence……

“Historical Perspective” Slides from Nancy Mather

Name:_____________________ Age: ____ Grade: ____ Examiner:____________________ Date: ___________

KABC-II and KTEA-II Data with WJ III as Supplement

Ga Broad/Narrow ClusterNonsense Wd Decod( )Phonol. Awareness_( ) WJ III Auditory Atten.(___)

Grw Broad/Narrow ClusterReading Composite( )Sound Symbol ( ) Reading Fluency__(_ _)

Gsm Broad/Narrow ClusterWord Order__ ( )Number Recall_ ( ) WJ III Working Mem. (__)

40 50 60 70 80 90 100 110 120 130 140 150 160

Gv Broad/Narrow ClusterRover _ __( )Triangles_______ ( )_______________( )

Gf Broad/Narrow ClusterStory Comp.__ ( )Pattern Reasoning ( _)_______________ ( )

Glr-MA Broad/Narrow ClusterRebus_____________(___)Atlantis_ __________(___)__________________(___)

Glr/Gs Broad/Narrow ClusterAssoc. Fluency_____(___)Naming Facility____(___)WJ III Gs Cluster__ (___)

40 50 60 70 80 90 100 110 120 130 140 150 160

Pattern of empirically or logically related cognitive

and academic deficits establishes basis for

satisfying criterion of “below average aptitude-achievement consistency”

Pattern of generally average cognitive

abilities and processes establishes basis for

satisfying criterion of “an otherwise normal

ability profile”

Gc Broad/Narrow ClusterExpressive Vocab. ( )Verbal Knowledge ( )_______________( )

Historical Concept of Intra-Individual Discrepancies

Domain-Specific

Unexpected Underachievement

Is “Otherwise Average Overall Ability” Consistent with the SLD Construct?

“Historical Perspective” Slides from Nancy Mather

How Do You Determine an “Otherwise Normal Ability Profile” or Otherwise

Average Ability

Clinical Judgment SLD Assistant (Flanagan, Ortiz & Alfonso, 2007) Instruments on which deficit areas do not contribute

to g estimate (e.g., GAI from WISC-IV) GAI (average or better) > WMI and PSI in SLD (Prifitera,

Soklofske, & Weiss, 2005) Pattern suggests Specific LD in Math (Geary et al., 2011)

Academic areas not related to referral Math achievement (average or better) > reading

achievement Informal observations and assessments, teacher

report CONVERGENCE OF INDICATORS

CD Included with Essentials of Cross-Battery Assessment, 2nd Edition (Flanagan, Ortiz, & Alfonso, 2007)

Is performance in Broad Area WNL or Higher?

Bob Gc = 109 Glr = 83 Gv = 100 Ga = 78 Gf = 112 Gs = 98 Gsm = 82

Bill Gc = 86 Glr = 80 Gv = 100 Ga = 78 Gf = 88 Gs = 87 Gsm = 79

g value =

Is performance in Broad Area Average (> 90) or Better?

Bob Gc = 109 Glr = 83 Gv = 100 Ga = 78 Gf = 112 Gs = 98 Gsm = 82

Bill Gc = 86 Glr = 80 Gv = 100 Ga = 78 Gf = 88 Gs = 87 Gsm = 79

g value = g value =

Broad CHC Abilities and SLD Assistant

g values close to 1 (e.g., .97, .98, .99) or higher Suggest that deficient areas are likely to be domain-

specific or circumscribed (vertical) Deficient areas may be amenable to remediation,

depending on the developmental level of the student Deficient areas may be readily accommodated or

compensated The greater the g value deviates from 1 in the

negative direction, the more likely it is that the student’s learning and achievement will be constrained by ability deficits Low average functioning in many cognitive and academic

areas – general learning difficulty (horizontal), not SLD Intellectual Disability Differential diagnosis requires consideration of data from

multiple methods and sources

Grw Broad/Narrow ClusterReading Composite( )Sound Symbol ( ) Reading Fluency__(_ _)

40 50 60 70 80 90 100 110 120 130 140 150 160

Gv Broad/Narrow ClusterRover _ __( )Triangles_______ ( )_______________( )

Gf Broad/Narrow ClusterStory Comp.__ ( )Pattern Reasoning ( _)_______________ ( )

Glr-MA Broad/Narrow ClusterRebus_____________(___)Atlantis_ __________(___)__________________(___)

40 50 60 70 80 90 100 110 120 130 140 150 160

Gc Broad/Narrow ClusterExpressive Vocab. ( )Verbal Knowledge ( )_______________( )

GENERAL Learning Difficulty

DOMAIN-GENERAL

EXPECTED Underachievement

(aka “Slow Learner”)

Glr/Gs Broad/Narrow ClusterAssoc. Fluency_____(___)Naming Facility____(___)WJ III Gs Cluster__ (___)

Gsm Broad/Narrow ClusterWord Order__ ( )Number Recall_ ( ) WJ III Working Mem. (__)

Name:_____________________ Age: ____ Grade: ____ Examiner:____________________ Date: ___________

KABC-II and KTEA-II Data with WJ III as Supplement

Ga Broad/Narrow ClusterNonsense Wd Decod( )Phonol. Awareness_( ) WJ III Auditory Atten.(___)

DIFFERENTIAL DIAGNOSIS IS IMPORTANT

A diagnosis identifies the nature of a specific learning disability and has implications for its probably etiology, instructional requirements, and prognosis. Ironically, in an era when educational practitioners are encouraged to use evidence-based instructional practices, they are not encouraged to use evidence-based differential diagnoses of specific learning disabilities.

Virginia Berninger (2010)

On the Flanagan et al. and Kavale and Forness Operational Definitions of SLD…

These operational definitions provide an inherently practical method for SLD identification that carries the potential for increased agreement

about the validity of SLD classification

Kavale, Holdnack, & Mostert (2005, p. 12)

The Importance of Assessing Cognitive Abilities and Processes and Academic Skills…

By identifying specific targets for remediation, the possibilities for truly

individualized intervention are increased significantly.


The Value of Assessing Cognitive Abilities and Processes…

Even if a student never enters the special education system, the general education teacher,

the student’s parents, and the student him- or herself would receive valuable information regarding why there was such a struggle in acquiring academic content, to the point of

possibly needing special education


Conclusions

Correspondence Between Diagnosis

and Treatmentas syndromes/disorders become more discretely defined, there may be a greater correspondence between diagnoses and

treatment

Kratochwill and McGivern's (1996; p. 351)

Subtypes of Reading Disability

Dysphonetic Dyslexia – difficulty sounding out words in a phonological manner

Surface Dyslexia – difficulty with the rapid and automatic recognition of words in print

Mixed Dyslexia – multiple reading deficits characterized by impaired phonological and orthographic processing skills. It is probably the most severe form of dyslexia.

Comprehension Deficits – the mechanical side of reading is fine but difficulty persists deriving meaning from print

(Ga-Phonetic Coding; Gsm-Memory Span, Working Memory)

(Glr-Naming Facility; Gv-Orthographic Processing; Gs-Perceptual Speed; Gc-Vocabulary Knowledge)

(Multiple CHC abilities or processes involved; attention and executive functioning)

(Gf-Induction, General Sequential Reasoning; Gc- Language Development; attention and executive functioning)

Feifer, S. (2011). How SLD Manifests in Reading Achievement. In Flanagan & Alfonso (Eds), Essentials of Specific Learning Disability Identification. Hoboken, NJ: Wiley.

Gf Gc

VL

Gv

VM

Glr

NA

Gsm

MW

Ga etc

OrthP

Gs

Criterion DVs

Predicting the 4 Subtypes of Reading Disability

I,RG LD,MY

VL

VM

VM NA

MW

MWPC

EF, AC

OrthP

PC Dysphonetic

DyslexiaSurfaceDyslexia

Mixed Dyslexia

Comprehension Deficits

= most likely a strong predictor

= most likely a moderate predictor

= most likely non-significant

Note: four subtypes from Feifer (2011); identification of IVs from Flanagan; Figure adapted from McGrew (2010)

Correspondence Between Diagnosis

and Treatmentas syndromes/disorders become more discretely defined, there may be a greater correspondence between diagnoses and

treatment

Kratochwill and McGivern's (1996; p. 351)

Measures and Processes involved

suggested by Flanagan

Includes contributions by

many school neuropsychologists:

Dan Miller, Brad Hale, Scott Decker,

Cecil Reynolds, Cynthia Riccio, and

more

Nudging the Field….

[email protected]

Crossbattery.com

mailto:[email protected]

Assessment for Differential Diagnosis of Learning Problems and Intervention Dawn P. Flanagan, Ph.D....

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