The Morris Center - NOW! Programs...The Morris Center *! Ocala and Gainesville, FL Neuro-development...
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Tim Conway, PhD * The Morris Center *! Ocala and Gainesville, FL Neuro-development of Words – NOW! * International The Einstein School * (a free, public charter school for children with dyslexia) University of Florida * Dept. of Clinical and Health Psychology Dept. of Speech, Language and Hearing Sciences Is it Ever Too Late? – Library Literacy Services for Adults with Reading Difficulties or Dyslexia
Transcript of The Morris Center - NOW! Programs...The Morris Center *! Ocala and Gainesville, FL Neuro-development...
Tim Conway, PhD*
The Morris Center*!
Ocala and Gainesville, FL
Neuro-development of Words – NOW!* International
The Einstein School* (a free, public charter school for children with dyslexia)
University of Florida* Dept. of Clinical and Health Psychology
Dept. of Speech, Language and Hearing Sciences
Is it Ever Too Late? – Library Literacy Services for
Adults with Reading Difficulties or Dyslexia
Human Neuroscience & Neuropsychology Complex challenges
Post-Stroke Phonological Alexia (poor reading skills)
Remediation of Genetic, Developmental Dyslexia
Prevention of Genetic, Developmental Dyslexia
Research Research-based versus Evidence-based
Components of Effective Reading Instruction
Case Studies
Library-based Adult Literacy Services in Alachua County, Florida
Conclusions and Future Directions
Can we make changes in neural synapses or networks?
At what age do human’s neurons lose the ability to make new connections (synapses) with other neurons?
Does each person’s brain work differently?
Does each person learn differently?
HOW does the human brain learn? 1. Sensory input, then….
2. Integration of sensory input “fire together wire together”
3. Processing skills/cognition
4. Behaviors
Neuroplasticity or LEARNING is promoted by: 1. Intensity - # of hours per day 2. Frequency - # of days per week 3. Specificity – explicit instructions/methods 4. Neurodevelopmental Hierarchy – training basic skills before advanced skills 5. Duration – # of weeks of treatment
Research-based methods/instruction Based on research related to the program being used,
e.g. Orton-Gillingham is based on studies that phonics instruction is important to learning
Evidence-based methods/instruction A specific, scientific method study or studies of a
program (instructional approach) have been conducted and reported in professional, peer-reviewed publications. Scientific Method
Theory
Hypotheses
Research Design
Results & Analyses
Conclusions
noun
a method of procedure that has characterized natural science since the 17th century, consisting in systematic observation, measurement, and experiment, and the formulation, testing, and modification of hypotheses.
Penicillin Does it work in FLORIDA
Does it work in Michigan
Does it work in Europe
Does it work…….
STG (bilateral)
acoustic-phonetic
speech codes pMTG (left)
sound-meaning interface
Area Spt (left)
auditory-motor interface pIFG/dPM (left)
articulatory-based
speech codes
Hickok & Poeppel (2000), Trends in Cognitive
Sciences
Hickok & Poeppel (2004), Cognition
STS phoneme
representations
UNIQUE AND OVERLAPPING NETWORKS SENTENCE/SYNTACTIC, SEMANTIC, PHONOLOGICAL (Vigneau, et al., 2006)
Developmental “Language Building Blocks”
building a solid foundation for reading
C O M P R E H E N S I O N
(MEANING)
(FORM)
READING
WRITING
SPELLING
METALINGUISTICS
SOUND OUT
WORDS (phonology/decoding)
SIGHT WORDS (Visual Memory)
SIGHT WORDS (visual memory)
VOCABULARY (Semantic Knowledge)
VOCABULARY (semantic knowledge)
SYNTAX
R E A D I N G F L U E N C Y
MORPHO-
SYNTACTIC
Typical READING Development
PHONICS RULES
SYNTACTIC
SEMANTIC/
LEXICAL
EXECUTIVE FUNCTION / INTENTION
WORKING MEMORY (HOLD / MANIPULATE)
ORTHOGRAPHIC ARTICULATORY PHONOLOGIC PROSODIC
ATTENTION / AROUSAL
(Alexander & Slinger, 2004)
EXECUTIVE FUNCTION / INTENTION
WORKING MEMORY (HOLD / MANIPULATE)
ACOUSTIC VISUAL ORAL MOTOR SOMATOSENSORY
ATTENTION / AROUSAL
PHONEMIC REPRESENTATION
PROSODIC (WORD LEVEL)
(Alexander & Slinger, 2004)
PHONOLOGY
(PERCEPTION & PRODUCTION)
18 MONTHS
5 YEARS
9 YEARS
1 MONTH
9 MONTHS
PHONOLOGY
(FORM)
PRAGMATICS
(FUNCTION)
SEMANTICS
(MEANING)
SYNTAX
(FORM)
READING
WRITING
SPELLING
METALINGUISTICS
Developmental Building Blocks
for Language (Alexander & Heilman, 2006; adapted)
Re
cep
tiv
e L
an
gu
ag
e
Ex
pre
ssiv
e L
an
gu
ag
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Dyslexia => Dys = difficulty & lexia = words
Poor skills in Reading
Neurological in origin Adult learners’ difficulty may be environmental or
due to injury or due to …..
Lifelong, but environment may alter course
Core deficit = “phonological language skills”
Accompanying Challenges (~50%) ADHD Sensorimotor Behavior problems = More challenging to remediate
.. is NOT A VISUAL PROBLEM
.. is NOT A LACK OF INTELLIGENCE
.. is NOT DUE TO LACK OF EFFORT
..is NOT IMPROVED BY STANDARD READING INSTRUCTION
.. is NOT UNCOMMON: 5–17.5 % OF POPULATION
.. is NOT A DEVELOPMENTAL LAG
MORPHO-
SYNTACTIC
Atypical READING - Dyslexia
PHONICS RULES
SYNTACTIC
SEMANTIC/
LEXICAL
EXECUTIVE FUNCTION / INTENTION
WORKING MEMORY (HOLD / MANIPULATE)
ORTHOGRAPHIC ARTICULATORY PHONOLOGIC PROSODIC
ATTENTION / AROUSAL
Biology (RAMUS, 2004)
Behavior
Cognition
“OUT OF LINE NEURONS” (ECTOPIAS)
FRONT BACK
www.thebrain.mcgill.ca
NEURONAL
MIGRATION and
“OUT of LINE
NEURONS”
(Ramus, 2004)
Disciplines: Neuropsychology
Psychiatry
Clinical Psychology
Occupational Therapy
Speech-Language Pathology
Education
DEVELOPMENTAL DYSLEXIA: A MOTOR-ARTICULATORY FEEDBACK HYPOTHESIS
(HEILMAN, VOELLER, ALEXANDER, 1996 Annals of Neurology)
“The inability to associate the position of their articulators with speech sounds may impair the development of phonological awareness and the ability to convert graphemes to phonemes. Unawareness of their articulators may be related to programming [sensory integration] or feedback [sensory perception] deficits.”
Alexander, Anderson, Heilman, Voeller, Torgesen (1991). Phonological Awareness Training and Remediation of Analytic Decoding Deficits in a Group of Severe Dyslexics. Annals of Dyslexia, 41, 193-206.
T. Conwaya,b,c, D. Szelesa,b, F. Bowdenb, S. Uhazieb,c, J. Gilberta, C. Hamma, P. Prilutskya, B. Crossona,b, &
L. Gonzalez-Rothia,b,c,d
aVA RR&D Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, Florida
bUniversity of Florida, Department Clinical and Health Psychology, Gainesville, Florida cUniversity of Florida, Department of Speech, Language and Hearing Sciences, Gainesville, Florida dUniversity of Florida, Department of Neurology, Gainesville, Florida
Acknowledged support:
VA RR&D Center of Excellence (#B3149-C), Career Development (C2743V & B6699W), and Career Scientist awards (B5083L & B6364L).
Preventing Reading Failure in Young Children with Phonological Processing Disabilities:
Group and Individual Responses to Instruction
Joseph K. Torgesen
Richard K. Wagner
Carol Rashotte
Elaine Rose
Patricia Lindamood
Tim Conway
Cyndi Garvan
(1999). Journal of Educational Psychology 91, 579-593.
*NICHD, National Center for Learning Disabilities, Donald D. Hammill Foundation
Dyslexia Prevention Study - using a “BOTTOM-UP” approach
NTC
RCS
EP
NOW! Foundations
0
5
10
15
20
25
30
35
40
45 Percent retained in K or 1st
(Torgesen, et al, 1999)
Per
cen
t
Perc
en
t R
etai
ned
Group (control & treatments)
A SOLUTION TO THE READING FLUENCY GAP: PREVENTION
10th 10th
70
80
90
100
Accuracy
Rate
4th
GRADE
2nd
GRADE
30th % ile
BEGINNING % ile
TREATMENT AGE 5-6 5-6 (Torgesen et al, 2003)
WORD READING
“…the PASP [NOW! Foundations®] treatment, as delivered in this study, was relatively ineffective in normalizing the phonetic reading skills of approximately [only] 2.4% of children in the total population [180] from which our treatment sample (the bottom 10%) [of ~1,854 children] was selected.”
(Torgesen, Wagner & Rashotte, 1997; Torgesen, et al., 1999)
Intensive Remedial Instruction for Children with Severe Reading Disabilities: Immediate and
Long-term Outcomes from Two Instructional Approaches
Joseph K. Torgesen
Ann W. Alexander
Richard K. Wagner
Carol Rashotte
Kytja Voeller
Tim Conway
(2001). Journal of Learning Disabilities, 34, 33-68.
Supported by NICHD, NCLD, DDHF
Immediate and Long Lasting Improvement (Decoding + Comprehension)
Sta
nd
ard
Sco
re
75
80
85
90
95
Initial
Test
Pre-
Treatment
Test
Post-treatment
test results
1 Year
After
Treatment
2 years
Normal Range of Performance
9-Week Intensive
NOW! Foundations
Torgesen, et al., 2001
16 Mos.
Special Ed Class
GROWTH IN PHONEMIC DECODING DURING
INTERVENTION & FOLLOW-UP
60
70
80
100
Pretest Posttest 1 year 2 years
90
NOW! Foundations
Torgesen, et al., in A.J. Fawcett (Ed), 2001
STRONG
ACTIVITY
PATTERN
weak activity
pattern
BRAIN ACTIVITY DURING READING
“SIGNATURE” DYSLEXIC BRAIN
Simos, et al 2002
Effective Treatment Changes Brain Activity/Networks
- in Developmental Dyslexia
(Simos, et al., 2002)
left left right right
Decreased activity in right hemisphere
Treatment = Increased activity in left hemisphere
Pre-Treatment S-3 Pre-Treatment S-4
After Treatment S-3 After Treatment S-4
Altering Cortical Connectivity – Remediation Induced Changes in the white matter for poor readers.
www.emschool.org
0
50
100
150
200
250
300
350
4th 5th 6th 7th 8th
GRADE
DE
VE
LO
PM
EN
TA
L S
CA
LE
SC
OR
E
FLORIDA STATE AVERAGE
ALACHUA COUNTY AVERAGE
EINSTEIN MONTESSORI
Einstein School’s FCAT results from 2005
AVERAGE CHANGE IN READING DEVELOPMENT
(IMPROVEMENT FROM 2004 TO 2005)
Disciplines: Neuropsychology
Psychiatry
Clinical Psychology
Occupational Therapy
Speech-Language Pathology
Education
Jon
020406080
100120140
PhonologicalAwareness
PhonologicalMemory
RapidNaming
AlternatePhonological
Awareness
AlternateRapid
Naming
Comprehensive Test of Phonological Processing
(CTOPP)
IQ = 98
76
115
70
7
6 79
103
94
112
97
94
0
0.2
0.4
0.6
0.8
1
Monolsyllables Polysyllables
DST Decoding Skills Test
0.48
Ph
on
ics
Tra
nsf
er
Ind
ex
Decoding Skills Test
Normal cutoff 0.74
0.93
0.72
0
20
40
60
80
100
120
Word Reading PseudowordDecoding
ReadingComprehension
WrittenExpression
Sta
nd
ard
Sco
re
Wechsler Individual Achievement Test - II
65
81 79
92
58
97
75
100
IQ = 98
84 99
92
117
90 103 101
114
0
20
40
60
80
100
120
140
Alachua County Library Adult Literacy Services:
# tutors trained in NOW! Foundations for Speech, Language, Reading and Spelling® program - 24
# learners being served with NOW! - 20
Total # learners served in program (ESOL and Literacy) – 59
Anecdotal Feedback and Report – NOT the Scientific Method.
Implementing NOW! in a volunteer-driven program can be challenging, but worthwhile things aren’t always easy to figure out at first glance…if it were super easy, everyone would be doing it. But that’s why I’m committed to the journey—to working out the kinks, going through the hiccups to get it all smooth enough to share with other similar programs. The training commitment for tutors is substantial, but it helps them self-weed…you may train fewer, but those who commit usually stay with the program and with their learners because they have invested. And with the small group approach, you can actually serve more learners in a dynamic way. And, at first glance, some programs may think it’s expensive… But when you compare the cost to the consumable materials purchased over one year, it’s not. It’s comparable, and may even save money once the kits are purchased. And, you cannot argue with science. I’m confident in our new direction and all the positive challenges it may include.
D., the star student tutor in July's training group, works with a learner who was a true zero-level, female, age 63. Never went to school...ever. Guessed at all the sight words and CVC words on the READ intake. Not one right.
Learner waited 4 months for a tutor. Just before I matched her with Diana she told me if this doesn't work out for her and she never gets to learn to read, she was going to "take herself off this earth“, so she wouldn't be a burden to her adult kids, and because her husband "stopped caring about me long ago“, so it wouldn't really matter anyway.
D. reported this right after starting to meet:
After my first lesson with S., I realized her phonological awareness was *VERY* limited. Just after FOUR actual tutoring sessions, about 7 hours, she expertly knows the three vowel sounds...she has markedly improved, and last class even SHE was saying how much she'd improved and that she thinks the program is working for her!
And reported this for September:
S. knows almost all the consonant pairs. She's pretty good at recognizing/segmenting/spelling with two-sound words. We're working on three-sound words now. She's always improving.
This from a tutor who went through the first training and continues:
“J. continues to make great strides in her reading. She uses the NOW! Foundations® material [method] to sound out words in her work in other books. She really notices differences in words and asks many questions in order to understand how language works. (This learner is in her 60s, compensated greatly through her life for her reading challenges, is the secretary for her church but always declines participating and reading unless it's part of her rote, memorized duties.)
From a tutor in the July group who was matched with a learner recently:
J. has mastered 4 consonant pairs. She can classify vowels into the smile, open or round and is beginning to discriminate between them sufficiently to place a few on the steps. (This learner is 54 years old and only went to 6th grade, and was in "special classes.")
Her biggest challenge is building confidence. Each time we practice reading and spelling J. is quicker and more sure of herself.
I love that students can master small chunks at a time with NOW! Foundations® and feel successful very early on.
“In my experience in volunteer based adult literacy programs, no matter the training, there is ALWAYS attrition. With Laubach, we would fill the room with 35 volunteers, they would be bored stiff and only half of them would actually want to be matched with a learner. If it were a two-part training, many never came back. I did that myself with a Laubach training many, many years ago—I left at the lunch break! So no volunteer-driven program is perfect. Until the government allocates funds for adult reading programs where we can pay more than just the coordinator, it will always be like this.”
