Learning Disabilitites

1

MS808 LEARNING DISABILITITES CASE STUDY #1

CHILDS INFORMATION: ......................................................................................... 4

Caveat .................................................................................................................................................................. 4 DIAGNOSIS ............................................................................................................ 4 Tests Administered ........................................................................................................................................................ 4 ASSESSMENT OF PSYCHOLOGICAL TEST RESULTS ................................................... 4 JJ Verbal Scale Sub-Tests Scores ......................................................................................................................... 5 No Signs of NVLD .............................................................................................................................................. 5 Leavells Categories Profile ........................................................................................................................................ 6 Check for ASD or Aspergers Syndrome ................................................................................................................ 6 No Signs of Dysgraphia .................................................................................................................................. 6 No Signs of Dyspraxia ..................................................................................................................................... 6 COBS ............................................................................................................................................................................... 6 No Signs of Dysgraphia .................................................................................................................................. 6 ADS .................................................................................................................................................................................. 6 Partial Signs of ADHD ..................................................................................................................................... 7 WISC-III Factor Indices ........................................................................................................................................... 7 ACoDS ............................................................................................................................................................................. 7 AIDS ................................................................................................................................................................................ 7 ADS .................................................................................................................................................................................. 7 VC/PO vs. ACID .......................................................................................................................................................... 7 No Signs of Neurological Impairment ....................................................................................................... 8 WSIC-III Developmental Index (WDI) .............................................................................................................. 8 Signs of Dyslexia .............................................................................................................................................. 8 Bannatynes Categories/Profile .......................................................................................................................... 8 ACID Profile ................................................................................................................................................................. 8 SCAD Profile ................................................................................................................................................................ 8 Borderline Signs of Social Incompetence ................................................................................................ 8 ASSESSMENT OF SENSORY PROCESS TEST RESULTS ................................................ 9 Signs of Sensory Processing Issues ...................................................................................................................... 10 Slosson Visual Perception Skill Screener ..................................................................................................... 10 Slosson Auditory Perception Skill Screener ............................................................................................... 10 ASSESSMENT OF ACHIEVEMENT TESTS RESULTS .................................................. 11 Bragg Phonics Readiness Test .......................................................................................................................... 11 Schonel Reading/Spelling Tests ...................................................................................................................... 11 Salford Sentence Reading ................................................................................................................................... 11 Neale Analysis of Reading Ability ................................................................................................................... 12

2

Signs of Reading and Spelling Issues ...................................................................................................... 12 ON-SITE OBSERVATION FROM CASE STUDY .......................................................... 12

BEHAVIOR AND SYMPTOMS MAPPING AGAINST DSM-IV-TR ................................ 13 Summary of Mapping Results ........................................................................................................................... 13 ASSESSMENT OF ADHD SYMPTHOMS TO DSM-IV-TR ............................................ 14 Symptom 1: Lack of Focus ....................................................................................................................................... 15 Symptom 2: Lack of Follow-Through .................................................................................................................. 15 Symptom 3: Lack of Organizational Ability ...................................................................................................... 15 Symptom 4: Lack of Sustained Mental Effort ................................................................................................... 15 Partial signs of ADHD .................................................................................................................................. 16 ASSESSMENT OF DSYLEXIA SYMPTHOMS TO DSM-IV-TR ...................................... 16 Symptoms of Dyslexia (DSM-IV-TR) .................................................................................................................... 16 Symptom 1: Reading achievement substantially below normalized standardized tests ....... 16 Symptom 2: Significant Interference with academic achievements ................................................ 16 Signs of Dyslexia ........................................................................................................................................... 17 AREAS OF CONCERN ............................................................................................ 17 Conflicting Assessment on Visual Perception ................................................................................................. 17 Possibility of Hearing or Hearing Frequency Loss ........................................................................................ 18 FURHER TESTS TO BE ADMINISTERED (IN TERMS OF PRIORITY IF NOT ALREADY DONE) .................................................................................................................. 18 Test for Hearing Loss ................................................................................................................................................. 18 Test for Visual Impairment ...................................................................................................................................... 18 Test for Visual Perception ........................................................................................................................................ 18 Motor-Free Visual Perception Test, Third Edition (MVPT-3) ............................................................ 18 Test for ADHD (Provisional) ................................................................................................................................... 19 The Attention Deficit Disorders Evaluation Scale - Third Edition (ADDES-3) ............................ 19 Devereux Scales of Mental Disorders (1994) ............................................................................................ 19 ASSESSMENT OF JJS STRENGTHS AND WEAKNESSES ........................................... 20 Summary of JJs Individual Factor Strengths and Weaknesses ................................................................ 20 Summary of JJs Cognitive Abilities ...................................................................................................................... 20 Excellent Concept Formation ............................................................................................................................ 20 Excellent Abstract in Thinking Skills ............................................................................................................. 21 Extremely weak Short Term Memory ........................................................................................................... 21 DIALOGICS ........................................................................................................... 21

CASE FOCUS ......................................................................................................... 21

KEY PEOPLE TO WORK WITH JJ ............................................................................. 22

Ideal Setup (Strongly Coupled Early Intervention Service Delivery) ......................................... 22 Educational Psychologist (Case Manager) ........................................................................................................ 22

3

Parents (Main Liaison, Key Co-Coordinator and Key Educator) ............................................................. 23 Educational Therapist (Main Implementer) .................................................................................................... 23 School (Main Academic Support) ........................................................................................................................ 23 Government Agencies (Main External Assistance) ....................................................................................... 24 FURTHER INFORMATION REQUREMENTS ............................................................. 24 Parents and JJ ................................................................................................................................................................. 24 Educational Psychologist and Educational Therapist .................................................................................. 25 School ................................................................................................................................................................................ 26 DIDACTICS ........................................................................................................... 29

Various Potential Outcomes in the diagnosis of JJs Dyslexic symptoms ................................... 29 Focus on Treatment of dysphoneidesia. ............................................................................................................ 29 Intervention Objectives ............................................................................................................................................. 29 Symptoms of dysphoneidesia ................................................................................................................................. 30 Analysis ............................................................................................................................................................................ 30 Proposal ........................................................................................................................................................................... 31 Comparison with WITHDRAWAL and INCLASS ............................................................................................. 32 How this proposal capitalizes on JJs strengths and minimizes his weaknesses ............................. 33 Performance Evaluation ........................................................................................................................................... 34 CONCLUSION ....................................................................................................... 34

BIBLIOGRAPHY ..................................................................................................... 35

APPENDIX 1 ......................................................................................................... 36

Kurzweil Education Systems High Stakes Testing ............................................................................. 36 Scientifically-Based Research Validating Kurzweil 3000 ............................................................... 36 APPENDIX 2 ......................................................................................................... 37

JJ WSIC- III Test Results .............................................................................................................................. 37

4

EVALUATION OF NEUROPSYCHOLOGICAL AND EDUCATIONAL TESTING

Childs Information: Name: JJ Chronological Age: 11yrs 6 mths Mental Age: 12 yrs 4 mths Gender: Male Grade: Primary 5

Caveat As the test dates were not provided in the case study, we assumed that all tests were

conducted at JJs chronological age so that we can have across the board consistency

in our evaluation.

Diagnosis

Tests Administered Wechsler Intelligence Scale for Children-III, Slosson Visual Perceptual Skill

Screener, Slosson Auditory Perceptual Skill Screener, Bragg Phonics Reading Test,

Schonnel Reading/ Spelling Tests, Salford Sentence Reading Test, Neale Analysis of

Reading Ability.

Assessment of Psychological Test Results JJ shows symptoms of both Dyslexia and ADHD but there are no signs of ASD.

Socially, he may show a devil may care attitude and socially highly tolerant of his

peers due to:

a. Issues with auditory processing (he cannot understand what they are saying

(shown by below cut-off scores in semantic and symbolic orientation);

5

b. A limited ability to relate different concepts (shown by below cut-off score in

pragmatic reasoning).

JJ Verbal Scale Sub-Tests Scores VERBAL SCALE (3 pts. significant)

Scaled Scores

Difference from Verbal Mean 1

Qualitative Description (based on

scaled scores)

Information (I) 6 -3 Extremely Low

Similarities (S) 11 2 Average

Arithmetic (A) 9 0 Average

Vocabulary (Vo) 10 1 Average

Comprehension (C) 11 2 Average Digital Span (DS) 7 -2 Low

PERFORMANCE SCALE (4 pts. significant)

Scaled Scores

Difference from Perf. Mean 2

Qualitative Description (based on

scaled scores) Picture Completion (PC) 11 1 Average

Picture Arrangement (PA) 12 2 Average

Block Design (BD) 12 2 Average

Object Assembly (OA) 11 1 Average

Coding (Cod) 9 -1 Average

Symbol Search (SS) 8 -2 Average

Mazes (Mz) 8 -2 Average

No Signs of NVLD

Test for Non-Verbal Learning Disability (VIQ PIQ >15)

Comment: Test results suggest that JJ does not show any signs of NVLD,

Autism or Asperger.

1 Verbal Mean is the sum of all tested factors divided by the number of tested factors. 2Performance Mean is the sum of all tested factors divided by the number of tested factors.

6

Leavells Categories Profile

Leavells Categories (31) > Cut-off (30):

Comment: Test results suggest that JJ does not show any signs of Autism or

Asperger.

Check for ASD or Aspergers Syndrome

SCV(32) > Cut-off (30): BO(23) > Cut-off (20): SCV(32)/3 = 10.7: BO = 23/2 = 11.5 Difference = 0.8 < 1 Comment: Test results suggest that JJ does not show any signs of Autism or

Asperger.

No Signs of Dysgraphia

ADSCodSS(33) < Cut-off (40).

Comment: ADSCodSS shows no possibility of dysgraphia.

No Signs of Dyspraxia

COBS

COBS (40) < Cut-off (40).

Comment: COBS shows no possibility of dyspraxia.

No Signs of Dysgraphia

ADS

ADSCodSS( 33) < Cut-off (40).

Comment: ADSCodSS shows no possibility of dysgraphia.

7

Partial Signs of ADHD

WISC-III Factor Indices

FDI (16) < 20) ; VCI (38) < Cut-off (40); PSI (17) < Cut-off (20).

Comment: WSIC-III Factor Indices suggest that JJ has auditory-sequential

processing deficit with ADHD like symptoms.

ACoDS

ACoDS (25) < Cut-off (40).

1. Comment: ACoDS Profile suggests that JJ shows signs of attention-

concentration span deficit, which is one of the symptoms of ADHD.

AIDS AIDS (22) < Cut-off (30)

2. Comment: AIDS Profile suggests that JJ shows signs of impulsivity, which is

one of the symptoms of ADHD.

ADS

ADS(16) < Cut-off (20).

3. Comment: ADS Profile suggests that JJ shows signs of distractibility, which is

one of the symptoms of ADHD.

VC/PO vs. ACID

VC(38) > ACID(31); PO(46) > ACID(31)

Comment: VC/PO vs. ACID profile suggests that JJ shows no signs of ADHD.

8

No Signs of Neurological Impairment

WSIC-III Developmental Index (WDI)

WDI (-0.03) < 0.20 (No impairment)

Comment: WDI suggests that JJ dies not have any sign of neurological

impairment.

Signs of Dyslexia

Bannatynes Categories/Profile

Spatial (Sp) [34] > Conceptual (Cpt) [32] > Sequential (Sep) [28] Comment: Bannatynes Categories/Profile suggest that there are possibilities

of classical dyslexia/ Specific Learning Disorder:

ACID Profile

ACID (31) < Cut-off (40). Comment: ACID Profile suggests that JJ shows signs of SpLD and ADHD.

SCAD Profile

SCAD (33) < Cut-off (40).

Comment: SCAD Profile suggests that JJ shows signs of SpLD.

Borderline Signs of Social Incompetence Social Relations (34) > Cut-off (30);

Semantic Orientation (27) < Cut-off (30);

Symbolic Orientation (25) < Cut-off (30);

Abstract Reasoning (32) > Cut-off (30);

9

Pragmatic Reasoning (29) < Cut-off (30);

Mean Score (29.4) < Cut-off (30).

Comment: Social Competence Profile suggests that overall JJ should be able

to communicate in a social setting (borderline mean score). He is likely to be:

a. Handicapped by his lack of general knowledge (I) when taking to his

friends (semantic orientation);

b. A limited ability to respond quickly to auditory questions and may

display excessive anxiety (symbolic orientation).

c. His lack of general knowledge (I) will also impede this ability to

connect the dots (pragmatic reasoning).

Assessment of Sensory Process Test Results JJ has severe auditory perception issues with some limitations to his visual perception.

In terms of visual perception, JJ may have difficulties perceiving or locating objects

within a busy field without getting confused by the background or surrounding

images (Visual Figure Ground). He has fewer issues with visualizing a complete

whole when presented with an incomplete picture (Visual Closure).

In terms of auditory processing, JJ can hear well but is apparently unable to

understand what he hears. JJ cannot hear well when there are other noises in the

background (significant age difference in Auditory FigureGround). JJ has severe

issues in recognizing words when spoken to him (significant age difference in

Auditory Filtered Words) and he comprehends rhyming words very poorly

(significant age difference in Auditory Filtered Words).

10

Signs of Sensory Processing Issues The Slosson Visual Perception Skill Screener and the Slosson Auditory Perception

Skill Screener are used to assess the child ability to perceive visual and auditory

information. Generally recommended for testing children between the ages of 5 and

10 years. All tests suggest that JJ visual and auditory perception skills issues.

Slosson Visual Perception Skill Screener Subscales Age Equivalent Difference from

Chron. Age (11 yrs. 6 mths)

Visual Discrimination

11 yrs. 7 mth + 1 mth

Visual Figure-Ground

10 yrs. 11 mths -7 mths

Visual Closure

11 yrs. 4 mths - 2 mths

Slosson Auditory Perception Skill Screener Subscales Age Equivalent Difference from


Auditory Figure-Ground

7 yrs. 3 mths -4yrs 3 mths

Auditory Filtered Words


Auditory Word Discrimination


11

Assessment of Achievement Tests Results

Bragg Phonics Readiness Test Subscales Raw Score Comments

Initial Letter Sounds

6/10

Final Letter Sounds 4/10

Rhyming Words

4/10

Non-words (Blending)

4/10 Reading difficulty

Readiness Level 1/10 Poor

Schonel Reading and Spelling Test are graduated normalized tests that provide an indication of age group equivalency.

Schonel Reading/Spelling Tests Skills Age Equivalent Difference from


Reading 9yrs 3 mths -2yrs 3 mths

Spelling 8yrs 9 mths -2yrs 9 mths

Salford Sentence Reading Test is a graduated normalized test that provides an indication of age group equivalency.

Salford Sentence Reading Skills Age Equivalent Difference from


Sentence Reading 10yrs 2 mths -1yrs 4 mths

12

Neale Analysis of Reading Ability is a graduated normalized test that provides an indication of age group equivalency.

Neale Analysis of Reading Ability Skills Age Equivalent Difference from


Reading Accuracy 9yrs 9 mths -1yrs 9 mths

Reading Rate 9yrs 2 mths -2yrs 4 mths

Reading Comprehension

10yrs 0 mths -1yrs 6 mth

Signs of Reading and Spelling Issues

All the tests suggest that JJ has difficulty in reading and spelling which are classical

symptoms of Dyslexia.

On-site Observation from Case Study

JJ is 10 years old (Primary 4) when his parents brought him to see an educational therapist (in

private practice) about getting him some help. He was about to start the new term at the

beginning of Primary 5 and his parents worried that he would not be able to cope with the added

workload. JJ has been in and out of learning support program (LSP) throughout his primary

school years, but he is still unable to keep up with his peers academically. He is a popular boy at

an all-boy school, pleasant mannered, teachers praise his efforts and he loves sport.

JJ's mother once said that JJ was struggling with his homework, and also bringing home-

unfinished schoolwork. Reading questions, following instructions, and putting his thoughts and

ideas down onto paper was a real struggle for JJ. Doing homework was a daily battle and could

13

take hours; the whole family was beginning to suffer from the effects of this, as there were

daily arguments.

JJ really enjoys football, but his coach was always getting at him to concentrate and focus a bit

more. JJ's confidence and self-esteem were rock bottom, his attitude was why bother I can't

do it, and so what's the point.

When JJ saw the educational therapist (in private practice) for the first session, he lacked

confidence and was unhappy about what the future held for him. Over the following 4 months

the educational therapist paid particular attention to building up his confidence, working on the

areas where he was having difficulty - reading, writing, concentration and self - esteem.

Through the use of specific, targeted, multi-sensory exercises tailored to JJ's requirements and

with a few exercises to do daily at home, JJ was beginning to show great improvements, and

was beginning to look forward to the move to high school.

Behavior and Symptoms Mapping against DSM-IV-TR

Summary of Mapping Results

Assessment Result

Intelligence Tests a. Signs of Dyslexia b. Partial signs of ADHD c. No signs of ASD d. No signs of neurological impairment e. No signs of dyspraxia f. No signs of dysgraphia

Sensory Processing Tests a. Severe auditory perception issues

b. Limited visual perception issues

Achievement Tests a. Severe reading disability

DSM-IV-TR a. Signs of Dyslexia b. Partial Signs of ADHD

14

ASSESSMENT OF ADHD SYMPTHOMS TO DSM-IV-TR To establish the validity of the assessment, all the symptoms shown by JJ should

conform to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition

(DSM-IV).

Diagnostic criteria for Attention-Deficit/Hyperactivity Disorder (Diagnostic and statistical manual of mental disorders, 2000).

A. Either (1) or (2):

(1) Inattention: six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

(a) Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities (b) often has difficulty sustaining attention in tasks or play activities (c) often does not seem to listen when spoken to directly (d) often does not follow through on instructions and fails to finish school work, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions) (e) often has difficulty organizing tasks and activities (f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework) (g) often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools) (h) is often easily distracted by extraneous stimuli (i) is often forgetful in daily activities

(2) Hyperactivity-impulsivity: six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

Hyperactivity

(a) Often fidgets with hands or feet or squirms in seat (b) often leaves seat in classroom or in other situations in which remaining seated is expected (c) often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness) (d) often has difficulty playing or engaging in leisure activities quietly (e) is often "on the go" or often acts as if "driven by a motor" (f) often talks excessively

Impulsivity

15

(g) Often blurts out answers before questions have been completed (h) often has difficulty awaiting turn (i) often interrupts or intrudes on others (e.g., butts into conversations or games)

B. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years.

C. Some impairment from the symptoms is present in two or more settings (e.g., at school [or work] and at home).

D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.

E. The symptoms do not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and are not better accounted for by another mental disorder (e.g., Mood Disorder, Anxiety Disorder, Dissociative Disorders, or a Personality Disorder

Symptom 1: Lack of Focus Often fails to give close attention to details or makes careless mistakes in schoolwork,

work, or other activities. In football, JJs coach was asking him to concentrate and

focus more.

Symptom 2: Lack of Follow-Through Often does not follow through on instructions and fails to finish school work, chores,

or duties in the workplace (not due to oppositional behavior or failure to understand

instructions) (homework). JJ was bringing back uncompleted schoolwork.

Symptom 3: Lack of Organizational Ability Often has difficulty organizing tasks and activities (putting thoughts down). Putting

his thoughts down on paper was a real struggle.

Symptom 4: Lack of Sustained Mental Effort

16

Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental

effort (such as schoolwork or homework). Doing homework was a daily battle and

could take hours.

Partial signs of ADHD JJ partially meets the DSM-IV-TR requirements for ADHD. Four symptoms have

been shown. Six symptoms are required to be present under at least two different

settings. We have only seen limited evidence in the home and at the football field.

ASSESSMENT OF DSYLEXIA SYMPTHOMS to DSM-IV-TR

Symptoms of Dyslexia (DSM-IV-TR) Diagnostic criteria for 315.00 Reading Disorder (Diagnostic and statistical manual of mental disorders, 2000)

A. Reading achievement, as measured by individually administered standardized tests of reading accuracy or comprehension, is substantially below that expected given the person's chronological age, measured intelligence, and age-appropriate education.

B. The disturbance in Criterion A significantly interferes with academic achievement or activities of daily living that require reading skills.

C. If a sensory deficit is present, the reading difficulties are in excess of those usually associated with it.

Symptom 1: Reading achievement substantially below normalized standardized tests JJ scored below average on the Bragg Phonics Readiness Test, Schonell Reading

Test, Salford Sentence Reading Test and Neale Analysis of Reading Ability.

Symptom 2: Significant Interference with academic achievements

17

Signs of Dyslexia JJ demonstrated gradually declining scores in his school examinations. He also

struggled with his schoolwork so much so that it interfered with the familys daily

living activities.

Areas of Concern

Conflicting Assessment on Visual Perception

According to the WSIC-III psychological pattern profile, JJs visual perception is

average but he is below equivalent age on the Slosson Visual Perception Tests (Visual

18

Figure Ground) and he has poor Coding (Cod) and Symbol search (SS) scores. Poor

Cod and SS scores may indicate visual dyslexia (dyseidesia).

Possibility of Hearing or Hearing Frequency Loss JJ auditory perception could be due to hearing or frequency loss. This would impair

his ability to distinguish, discriminate between words and comprehend words

especially in a noisy environment.

FURHER TESTS TO BE ADMINISTERED (IN TERMS OF PRIORITY IF NOT ALREADY DONE)

Test for Hearing Loss Although it is likely that JJ is dyslexic, he also appears to have severe auditory

perception and auditory processing. We need to ascertain that hearing problems are

not the root causes of his dyslexic symptoms. An audiologist can administer this test.

Test for Visual Impairment To ascertain that JJ is not suffering form any visual impairment that could give rise to

issues with visual perception, JJ should consult an Optometrist.

Test for Visual Perception

Motor-Free Visual Perception Test, Third Edition (MVPT-3)

This tests would allow us to determine the extent of JJs visual perception (Ronald P.

Colarusso & Donald D. Hammill, 2012). Based on JJs Slosson Visual Perception

Test we would still need to ascertain if JJ also has mild dyseidesia. Educators,

psychologists, occupational therapists, optometrists may administer the test but the

overall assessment should be done by an educational psychologist.

19

Test for ADHD (Provisional) We need to ascertain whether JJ has ADHD or has induced ADHD-like symptoms

due to the stress caused by his dysphoneidesia. We would suggest further assessment

using the following tests only after having confirmed that JJ has all the ADHD

symptoms according to the DSM-IV-TR.

The Attention Deficit Disorders Evaluation Scale - Third Edition (ADDES-3) This is a questionnaire, which has a school version (60 items), and a home version (46

items). This test in conjunction with JJs developmental history, direct observation of

behavior under different setting, interviews and more specific neuropsychological

testing, provide a better diagnosis of whether JJ has ADHD (McCarney & Arthaud,

2004). The teacher or parent can administer this test but the assessment would need to

be done by an educational psychologist.

Devereux Scales of Mental Disorders (1994) The test has 111 items and is used to determine if the child is experiencing or is at risk

of an emotional disorder including ADHD. It is based on DSM-IV categories (Jack A.

Naglieri, Paul A. LeBuffe, & Steven I. Pfeiffer, 1994). An educational psychologist

administers and assesses this test.

20

Assessment of JJs Strengths and Weaknesses

Summary of JJs Individual Factor Strengths and Weaknesses Strengths Difference

from Mean Ability

a. Similarities (Sim) 2 May be able to do abstract and logical thinking.

b. Comprehension (C) 2 May be able to verbalize well and has good source of practical information.

c. Picture Arrangement (PA) 2 May have good planning abilities and logical sequential thought processes.

d. Block Design (BD) 2 May have well-developed non-verbal concept formation.

h. Information (I) -3 May have tendency to give up easily.

i. Digit Span (DS) -2 May have hearing loss and or poor auditory sequencing skills.

j. Symbol Search (SS) -2 May have impulsivity and poor visual tracking skills.

k. Coding (Cod) -1 May have visual-motor co-ordination problems and excessive anxiety.

Summary of JJs Cognitive Abilities

Excellent Concept Formation (CF = I (-3) + Sim(2) + Vo(1) + C(2) + PA(2) + BD(2) = 6)

21

JJ has good Concept Formation (CF). He is able to develop ideas based on the

common properties of objects, events, or qualities using the processes of abstraction

and generalization (The American Heritage medical dictionary, 2007).

Excellent Abstract in Thinking Skills (AT = DSim(2) + Vo(1) + BD(1) = 5) JJ has the ability to use concepts and to make and understand generalizations, such

as of the properties or pattern shared by a variety of specific items or events (The

American Heritage medical dictionary, 2007).

Extremely weak Short Term Memory (STM = A(0) + DS(-2) + Cod(-1) + SS(-2) = -5) JJ has poor ability to retain and recall recent events or experiences (The American

Heritage medical dictionary, 2007) .

DIALOGICS

CASE FOCUS The focus should be on helping JJ to overcome his dyslexia, which is likely to be

dysphoneidesia (dysphonesia comorbid with dyseidesia subtypes). We also need to

confirm if he has ADHD.

22

KEY PEOPLE TO WORK WITH JJ

Ideal Setup (Strongly Coupled Early Intervention Service Delivery)

Adapted from Early Intervention Service Delivery Models and Their Impact on Children and Families (Harbin & West, 1998).

Educational Psychologist (Case Manager) The Educational Psychologists would be the person who would co-ordinate and work

with other team members on helping JJ. He/she would review JJ progress periodically

and will be the main information center to turn to, for queries from government

agencies, the school and JJs parents.

23

The major assumptions made are that JJ is suffering from neither visual nor auditory

impairments that are the root causes of his dyslexic symptoms.

Parents (Main Liaison, Key Co-Coordinator and Key Educator) As JJs primary caregivers, JJ parents would be the persons responsible for ensuring

that the educational therapist carries out the recommendations made by the

educational psychologist and that the educational psychologist does the periodic

review of JJ. However, they are also JJ main educator and should implement the

learning and behavioral modification strategies that they have been taught to use by

the Educational Therapist. JJs parents would also be the main liaison persons

between the school, government agencies and the educational therapist with the

educational psychologist. They would also be responsible for collating information

regarding JJs progress for the educational psychologist to review on a periodic basis.

Educational Therapist (Main Implementer) The Educational Therapist would be responsible for implementing the

recommendations made by the educational psychologist and providing the necessary

guidance for JJs Parents, Allied Educator and School Teachers. This guidance will be

relayed to the school via JJs parents. The therapist would also be responsible for

gathering relevant information on JJ for future review purposes.

School (Main Academic Support) The Allied Educator and School Teachers will receive guidance from JJs Educational

Therapist on the course of action that needs to be taken. Their role would be to

implement the action plan and provide relevant information for future review

purposes.

24

Government Agencies (Main External Assistance) Government agencies may be providing assistance such as extended time to do exams

or wavering of the Mother Tongue exam requirements (MOE). JJs parents will act as

the main liaison person between the educational psychologist and the government

agencies or VWO such as the Dyslexic Association of Singapore (DAS).

FURTHER INFORMATION REQUREMENTS

Parents and JJ

Adapted from Why EI works (Guralnick, 2011)

Through interviews with both JJ and his parents, I would use the Guralnick

framework above to discover information on:

1. JJs Social and Cognitive Competence.

2. JJs Parent-Child Transactions.

3. JJs Family Orchestrated Child Experiences.

25

4. Evidence of JJs dysphoneidesia and/or onset of ADHD symptoms.

5. Health and safety aspects provided by the parents.

Educational Psychologist and Educational Therapist

Adapted from What is LD in Special Needs Education (Chia, 2012).

I would use chart above developed by Chia (2012) to:

1. Develop a common understanding of the operating definitions of various LDs

between the educational therapist and the educational psychologist.

2. More effectively and clearly, identify the severity and the type of LD affecting

JJ.

3. Maintain awareness that a combination of levels results in a syndrome so

treatment must not mitigate one symptom but gravely increase the severity of

another.

26

4. Apply the common knowledge to JJs psychological and sensory assessment

results.

5. Review the current treatment, what it is supposed to do and how it has

benefited JJs progress according to established goals.

6. Come to a common understanding of whether the treatment was successful

and prioritize which LD to treat based on severity.

7. Determine what treatment would benefit the behavioral aspects and what

treatment would benefit the academic aspects.

8. This information would then be disseminated to the parents and the school.

School

Factors determining school readiness to accept children with learning disabilities

I used a self-developed framework using several sources of information from

UNICEF (Phillips, 2012), the Australian government project on improving school

readiness for learning disabled children (Victoria. Dept. of Education and Early

27

Childhood Development, 2008) and a comparative study on the impact of impairment

on children with special needs entering schools in Canada, Australia and Mexico

(Janus, 2011).

Using the above framework, I would seek to discover the schools readiness to accept

children such as JJ by asking some of the following questions:

1. School Culture:

a. Professional Collaboration

i. How good is the professional collaboration between teachers

and staff?

ii. How much planning and organizational time is used to plan as

collective units/ teams for the benefit of students and the

school?

b. Affiliative Collegiality

i. How strong is the espirit de corp amongst staff, teachers and

students?

ii. Is there a sense of community feeling in the school where each

school members tries to help each other?

c. Self-Determination

i. Are the school members proactive rather than reactive to

student needs?

ii. Is there sufficient empowerment?

iii. Do staff and teachers enjoy working there and choose to be

there?

2. School Facilities:

28

a. What facilities are available to help JJ overcome his dysphonesia or

dysphoneidesia if he has dyseidesia as well and/or ADHD?

3. School Professional Expertise

a. What professional expertise is available to help JJ overcome his

dysphonesia or dysphoneidesia and/or ADHD?

b. Would the teachers/staff be able to administer the treatment regime

recommended by the educational therapist on the advice of the

educational psychologist?

c. How ill they help JJ to cope with his schoolwork?

d. How will they support JJs parents?

29

Didactics

Various Potential Outcomes in the diagnosis of JJs Dyslexic symptoms

Focus on Treatment of dysphoneidesia. We will assume a worst-case scenario such that dysphoneidesia is the diagnosed

outcome and that ADHD symptoms were a consequence of his dyslexia. We refer to

the VC/PO vs. ACID that do not indicate that JJ has any ADHD.

Intervention Objectives

1. JJ to reach academic standards required by a Primary 6 level student in 2

years.

30

2. To create an intervention program that can have a high academic content but is

essentially family driven and managed through the home and school

environment.

3. To prevent decay in JJs intervention progress by having therapeutic

consistency the school to home environments.

4. Train JJs parents to provide the necessary support to JJ.

Symptoms of dysphoneidesia

1. A dyseidetic child has difficulties in making and immediate sight-sound

match.

2. A dysphonetic child may display great difficulty in syllabicating, sounding out

and blending the sounds together to decode the word.

Analysis

1. JJ needs to be able to pass his PSLE in 2 years time.

2. JJ is currently performing in English Language at 41% of Primary 4 level. If

we assume primary 5 level English Language requirement to be 100% and

Primary 6 English Language requirement to be 200% from Primary 4 level.

Then JJ who is performing at 41% of Primary 4 English Language Level

requirement is -159% (March) below Primary 5 English Level requirement.

Primary 5 Primary 6 March June Sept Dec March June Sept Dec Grades -159% -107.7% -56.4% -5.1% 46.1% 97.4% 148.7% 200% Rate 51.3% 51.3% 51.3% 51.3%

3. He needs an improvement of at least 51% each quarter to meet the intended

target.

31

Proposal

1. The best way to achieve the target is to incorporate JJ academic requirements

into his intervention therapy. So rather than focus on using reading material

and other teaching aides that are disconnected with the MOE syllabus, we will

use all the textbooks and reading material that will be used in the classroom.

2. I would recommend specialized software such as the Kurzweil Education

system (Kurweil Education System, 2012). There are many such different

software in the market. It is not our purpose to promote this software but to

demonstrate that the proper use of ICT can lead to a highly effective

intervention strategy. Appendix 1 contains the research material on this

software.

3. The system allows the teacher to conduct a normal class for mixed ability

students using standard textbooks. JJ would be able to access the textbook

material through his laptop because the textbook contents can be digitized and

stored in the software. External noise tat will distract JJ can be minimized

through him wearing noise cancelling headphones.

4. As the teacher explains on the board, JJ can follow the lesson through text-to-

voice and simultaneous word/sentence highlighting. He is able to see the

words and hear the words with minimal distraction. If he does not understand

the word, he can access the on-line dictionary. Alternatively, he can review the

word by clicking on the word to repeat the sound. This would enhance his

immediate sight-sound abilities.

5. The role of the Allied Educator would be to support JJ with his classroom

understanding by empowering him to better use the software and also to

identify any areas of weakness that may not have been properly covered by the

32

software. These weaknesses would be escalated to the educational therapist

and the educational psychologists for their follow-up.

6. When JJ comes home, the software can be used to help JJ to do his homework.

His parents can assist JJ by providing essentially the same support as the

Allied Educator and his schoolteacher.

7. The role of the educational therapist and educational psychologist would then

be to fine-tune and make adjustments in the manner that the software is used.

They can insert reading material that would specifically target areas of

weakness.

Comparison with WITHDRAWAL and INCLASS

33

The Achilles heel in any WITHDRAWAL and INCLASS program is that the Allied

Educator, not being a certified teacher, does not bridge their intervention strategies

with the class lesson plan. This proposal would avoid that shortcoming.

Conceptually the proposal meets the WITHDRAWL tasks.

1. JJ receives individual intervention (WITH).

2. JJs L&B performance is monitored and intervention provided where

necessary (DRAW)

3. There is complete assessment and evaluation of JJs L&B performance.

Conceptually the proposal meets the INCLASS tasks. The teacher is able to look not

JJ PLOP using the software. The teacher can also to modify the teaching material for

JJ specifically to meet his learning requirements. Follow-up assessment can be

generated through the software where JJ can be individually assigned tasks or short

tests that will ascertain his development.

How this proposal capitalizes on JJs strengths and minimizes his weaknesses

JJ has excellent concept formation; excellent abstract thinking but is extremely weak

in short-term memory. The software allows JJ to learn at his own pace whilst helping

him to decode words almost instantaneously.

Short-term memory (STM) is made up of Digital Span (DS), Coding (Cod) and

Symbol Search (SS). The software highlights each word as it is read out. This

strengthens JJs visual motor coordination (VMC), which is (Cod + SS) as well as his

Attention (DS + PC).

34

Any improvement in Cod and SS will result in improvements in Attention and

Concentration (Attn), Sequencing of Information (Seq), School like tasks (SLT), as

well as STM and VMC. There would be spillover improvements on Information (I) as

his knowledge base expands.

The advantage of this kind of software is that it can also be used for non-academic

reading materials so that JJ can develop a good reading habit. Neither is this software

limited to the learning of English so that it can also be used for JJs mathematics and

science. This software cannot be used for Chinese Language, as Chinese characters

are not recognized.

Performance Evaluation

JJs performance will be evaluated through the class tests and periodic testing by the

educational psychologist.

Conclusion JJs is likely to be suffering from dysphoneidesia that suggests that he has both visual

and auditory-linguistic dyslexia. He has partial symptoms of ADHD, which may have

been induced by his dyslexia.

Further tests would need to be carried out to eliminate visual and hearing impairments

but only for ADHD if interviews with JJ caregivers and teachers provide reliable

evidence pointing to ADHD. This is to avoid over testing JJ.

35

We assumed that he only has dysphoneidesia and will help JJ to overcome his

learning disabilities through the use of ICT, proper family and school support and

appropriate therapy under the supervision of an educational psychologists and

direction of an educational therapist.

Bibliography Chia, N. K. H. (2012). What is LD in Special Needs Education? Journal of the

American Academy of Special Education Professionals (JAASEP), Spring-Summer 2012, 7886.

Diagnostic and statistical manual of mental disorders: DSM-IV-TR. (2000).

Washington, DC: American Psychiatric Association. Guralnick, M., J. (2011). Why Early Intervention Works A Systems Perspective.

Infants and Young Children, v24 n1, 628. doi:10.1097/IYC.0b013e3182002cfe

Harbin, G. L., & West, T. (1998, March). Early Intervention Service Delivery Models

and Their Impact on Children and Families. Jack A. Naglieri, Paul A. LeBuffe, & Steven I. Pfeiffer. (1994). Devereux Scales of

Mental Disorders (DSMDTM). Janus, M. (2011). Impact of Impairment on Children with Special Needs at School

Entry: Comparison of School Readiness Outcomes in Canada, Australia, and Mexico. Exceptionality Education International, 21(2), 2944. doi:Article

Kurweil Education System. (2012).Kurweil Education System. Retrieved October 12,

2012, from http://www.kurzweiledu.com/high-stakes-testing.html McCarney, S. B., & Arthaud, T. J. (2004). ATTENTION DEFICIT DISORDERS

EVALUATION SCALE - Third Edition (ADDES-3). Retrieved from http://www.hawthorne-ed.com/images/adhd/samples/swf_files/h00850.pdf

Phillips, D. (2012). Early Childhood Development and Disability: A discussion paper.

UNICEF.

36

Ronald P. Colarusso, & Donald D. Hammill. (2012). Motor-Free Visual Perception

Test, Third Edition (MVPT-3). Western Psychological Services. Retrieved fromhttp://portal.wpspublish.com/portal/page?_pageid=53,69183&_dad=portal&_schema=PORTAL

The American Heritage medical dictionary. (2007). Boston: Houghton Mifflin.

Retrieved from http://www.credoreference.com/book/hmmedicaldict Victoria. Dept. of Education and Early Childhood Development. (2008). Blueprint for

early childhood development and school reform early childhood development, discussion paper. Melbourne: Dept. of Education and Early Childhood Development. Retrieved from http://www.eduweb.vic.gov.au/edulibrary/public/commrel/policy/Blueprint2008/bp_ecdevelopment.pdf

Appendix 1

Kurzweil Education Systems High Stakes Testing

Scientifically-Based Research Validating Kurzweil 3000

37

Appendix 2

JJ WSIC- III Test Results

Learning Disabilitites

Documents

Transcript of Learning Disabilitites