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									  Prevention and
 Intervention for
Writing Disabilities
         Presented by
     Nancy Mumm, MS. CCC
   Judith Rutberg-Self, Ph.D.
Two Compositions by Arthur
 The mn was sneB (2nd grade)
  (In response to a picture of a girl showing her father a
  large fish she had caught)


 I think theu shold no how to speek
  dififering langwges. If theu go to like
  dutch countri sombodie might ask them
  something theu cold have two kinds of
  langage. (5th grade)
  (In response to the teacher’s query, “Should children
   learn a second language?)
           April’s Story

When April starts to write, she feels overwhelmed. So she
writes as little as she can get away with ( and sometimes
less than she can get away with). She is often accused of
being lazy and irresponsible. She isn’t lazy at all. She
explains “Whenever I try to write, I lose my ideas and get
all mixed up about them. Then, when I see what I am
writing, it is all a big mess and the ideas that come out are
not the ones in my head. They look babyish and stupid.
Then I’m afraid that one of my friends will see what I
wrote or my teacher will show it to everyone or my parents
will get real mad and say that I wasn’t even trying. I hate to
write”.
Writing is a highly complex and
demanding process
 Organization

 Form and features

 Rules and mechanics

 Purposes and goals

 Audience needs and perspectives
The Writer Must Be
 Goal oriented

 Resourceful

 Reflective
  Writing – There’s more to it than
           meets the eye!
 Writing is not the mirror image of reading.
  Competent readers do not necessarily
  become competent writers.

 In addition to recognizing letters
  automatically, one must learn to produce
  letters automatically.

 Learning spelling patterns is more complex
  than learning to read them.
Writing – There’s more to it than
meets the eye!
 Putting ideas in writing is a more complex
  task than putting ideas into words.
  Children with difficulties in speech and
  language are at higher risk for writing
  disabilities.

 Learning to spell is more complicated than
  learning to read. There are many more
  speech- to- sound variations than letter-to-
  sound variations.
Writing – There’s more to it than
meets the eye!



     Writing is Language by Hand

     Reading is Language by Eye
 Learning to Talk is Different Than
         Learning to Write
 Speaking is a social interaction
  between cooperative, supportive
  partners.

 Writing is solitary and the
  responsibility of the communication is
  solely on the writer.
    Incidence of Written Language
              Disabilities
 Extremely prevalent in the population of children with
  learning disabilities

 Reading disabilities may be identified sooner, but writing
  disabilities are more persistent

 While there has been tremendous research in reading,
  writing research has been limited or ignored

 Children with oral language impairments are six times
  more likely to have difficulty reading (and hence writing)
  than typically developing peers (Catts)
    Common Behaviors of Writing
        Disabled Students
 Minimal planning- they draw information from
  memory that is somewhat appropriate, writing it down
  and using each idea to stimulate the generation of the
  next one (Graham)

 Minimal attempts at revision, revision tends focus on
  correcting mechanical errors

 Struggle with mechanics of writing – spelling,
  capitalization, punctuation, handwriting fluency

 Overemphasize mechanics over form and process of
  writing
          Current Writing Research
University of Washington - the “Write Stuff”
     for Preventing Writing Disabilities
 Ongoing Since 1989

 Principal Investigator – Virginia Berninger, Ph.D,
  Developmental Psychologist

 Funded by National Institute of Child Health and
  Human Development

 Focuses on writing development, causes of writing
  disabilities, and science-based treatment to remediate
  writing problems in children
 Myths and Realities about Writing
           Disabilities
   Abstract of a Decade of Research at the UW

 Myth 1:Reading Disability is the most
  common form of Learning Disability
 Reality: Writing Disability is more prevalent
   Children who initially struggle with reading
    usually learn to read but have residual writing
    problems
   Many children who can read well have writing
    problems
   Many students who perform poorly on State
    designed assessments of writing have
    undiagnosed writing problems
 Myths and Realities about Writing
           Disabilities
   Abstract of a Decade of Research at the UW

 Myth 2: Writing Disability is a Motor
  Problem
 Reality: Writing Disabilities, like reading
  disabilities, are heterogeneous

   Students may have difficulty with only one or a
    combination of specific problems

   The most common contributing process in
    elementary school is handwriting and/or spelling

   Writing is fundamentally a language and
    conceptual activity
 Myths and Realities about Writing
           Disabilities
   Abstract of a Decade of Research at the UW

 Myth 3: Only higher level “conceptual
  processes” should be taught.

 Reality: Lower and higher levels of
  language need to be taught. The ability to
  write alphabet letters automatically is a
  very strong predictor of the quality of
  writing. Handwriting should be taught
  explicitly, not incidentally.
 Myths and Realities about Writing
           Disabilities
  Abstract of a Decade of Research at the UW

 Myth 4: Writing instruction should be
  aimed only at meaning and ideas.

 Reality: All areas of written language
  should be addressed within the same
  instructional session. Handwriting,
  spelling, and composition should be
  taught together, and instruction
  should be explicit.
 Two Types of Writing Disabilities Have Been
                Discovered
       University of Washington “The Write Stuff”




 One group has initial trouble learning
  to read, responds well to instruction,
  but has persistent writing disabilities

 Another group has writing disabilities
  without reading difficulties
Several Reasons for Writing
Difficulties University of Washington “Write Stuff”
 Underdeveloped spelling, handwriting, or
  composing skills, singly or in combination
 Processing problems including automatic letter
  retrieval and production, working memory,
  fine-motor planning, orthographic (visual) or
  phonological (auditory) coding of letters and
  words
 Attention Deficit Disorder/Executive Function
  Deficits
 Lack of a school program with coordinated,
  explicit instruction in writing
 Genetic studies have found written spelling
  difficulties to be inherited
            Handwriting
 Luria (Russian psychologist)
  described writing as a “Kinetic
  Melody” – and compared the act of
  writing to a finely tuned orchestra
  (many actions occurring at the same
  time)
           Kinetic Memory
 Requires balancing, flexing, and
  contracting movements as well as
  simultaneously stimulating some
  muscle groups while inhibiting other
  muscle groups, just as an orchestra
  requires the balancing of many
  different instruments, sound levels,
  and rhythms.
      Multiple Brain Mechanisms
              Handwriting
 Gross and Fine Motor Coordination
   Dyspraxia- difficulty getting the muscles
    to work together to cooperate in the
    right way to accomplish a motor action
   “I know what to do, I can explain it, but
    it’s just that my muscles won’t do it.”
   These students hold their pencil in an
    awkward way, or tightly, which helps
    them control their muscles better but
    can also make writing very slow.
      Multiple Brain Mechanisms
            Motor Memory
 Students with motor memory problems
  may take a long time to learn to form
  letters.

 Difficulty getting the motor movements
  (engrams) for letter formation to be
  automatic.

 Cursive writing may be difficult because of
  the hundreds of little movements needed to
  make and connect the letters
         University of Washington
               “Write Stuff”
               Handwriting
 Handwriting automaticity at an early age
  (writing alphabet letters quickly from
  memory) is a strong predictor of the quality
  of composition in older, normally
  developing writers.

 If letter production is automatic, then the
  child is able to attend to higher level
  composing processes, such as deciding
  what to write about, what to say, and how
  to say it.
           University of Washington
                 “Write Stuff”
                 Handwriting
Handwriting difficulties:

 Must be remediated EARLY!

 Handwriting must be explicitly practiced to make
  “motor program” (engram) automatic.

 Practice involves following numbered arrow cues for
  forming each letter – so letter production becomes
  automatized and uniform.

 It is difficult to remediate awkward hand position,
  even if attended to early.
University of Washington
“Write Stuff”
Spelling

 The ability to process the sound structure of spoken
  words (phonological awareness) is directly related to
  spelling.

 Learning to spell requires linking the spoken word to
  the written word, not simply visual memorization
  (look, cover, write).

 Children need to understand that the sound structure
  of words is related to the structure of written words,
  although not always in a perfect way.
University of Washington
“Write Stuff”
Spelling
 Children do not learn to spell or read “letter by letter

 Children need to understand that letters and letter units
  are used to translate units in the spoken word to units in
  the written word.

 Functional spelling units are usually one or two letters in
  size (ph, oa, ng)

 Children who learned associations for two letter spelling
  units made the most progress in learning to spell and
  recognize words.
University of Washington
“Write Stuff”
 Spelling
 Children need repeated practice writing
  specific words to dictation

 Exclusive reliance on incidental instruction
  during the “teachable moment” or use of
  personal dictionaries is not sufficient to
  teach spelling.

 A minimum of 24 practice trials, distributed
  over a 2 month period, was needed for at-
  risk 2nd graders to master spelling words.
Spelling requires more than
       sound/symbol
      correspondence!
University of Washington
“Write Stuff”
Composition

 In composition, journal writing is ineffective with
  students who have writing disabilities.

 Children need guided assistance in the form of
  prompts

 Graphic organizers are useful to help struggling
  writers plan what to write

 Teacher modeling in which the teacher thinks aloud
  while planning, is helpful for teaching struggling
  writers.
Multiple Brain Mechanisms
Involved in the Writing Process
  Writing requires the simultaneous and
    sequential integration of many sub-
                 processes
                                                              Integration of
     Memory                    Writing                           Multiple
 Spelling Patterns                                             Information
  Motor Memory                                                   Sources


Language and                                              Gross and Fine
Higher Order                                                Motor Skill
                           Executive Functions
  Cognition
                                  Attention                 Handwriting
 Vocabulary          Organization/Planning and Revising
 Semantics
                             Working Memory
        Executive              Functions


 Barkley: Those actions we perform to
  ourselves and direct at ourselves so as to
  accomplish self-control, goal directed
  behavior, and maximize future outcomes

 Brown: The conductor’s role in an orchestra

 McCloskey: A large collection of “semi-
  conductors”, each responsible for a
  separate aspect of the overall production of
  the orchestra, but each working in a
  collaborative manner with the others
Frontal Lobe = Command Center
Executive Function Control

  Internalizing
   Language
   (Self-Talk)


    Controlling
    Emotions

   Organization
   Planning and
     Revising

      Working Memory

                       Activation, Arousal, Effort,
                            Paying Attention
  What is Included in Executive
           Functions?
               Holding facts in mind while manipulating
information; accessing facts stored in long-term memory

         Activation, Arousal, and Effort (getting started; paying
attention; finishing work)

                     Ability to tolerate frustration; thinking before
speaking or acting

                    Using “self-talk” to control one’s behavior
and direct future actions

                 Taking an issue apart, analyzing the pieces
      Executive Functions of Writing
                Attention
 Attention
  •    Involved in planning and producing responses
       (April’s difficulty)
  •    Handwriting is often a problem in children with
       attention problems (location in brain)
  •    Some children with AD/HD who have
       handwriting problems show dramatic
       improvement in handwriting when given
       stimulant medication (Berninger)
  •    Writing development should be closely
       monitored in any child with AD/HD
   Executive Functions of Writing
             Attention
 Research by Mayes and Calhoun
  identified written expression as the
  most common problem of students
  with AD/HD (65%).
 Consequently, writing essays,
  drafting book reports, or answering
  questions on tests or homework is
  often very challenging for these
  students.
A Careful Diagnosis is Critical
    Executive Functions of Writing
          Working Memory
The ability to hold information in mind
  while processing and manipulating it

                                 Memory for
Spelling
                                 Facts and
 Rules
                                   Ideas
  and
Patterns



  Vocabulary   Motor Programs
  and Word                       Mechanics
               Forming Letters
   Finding
   Executive Functions of Writing
         Working Memory
 Written language difficulties include:
   Difficulties holding ideas in mind
   Quickly retrieving grammar, spelling,
    and punctuation rules from long-term
    memory
   Manipulating all this information
   Remembering ideas to write down
   Organizing material in a logical sequence
   Reviewing and correcting errors
  Problems that Impact Working
            Memory

 Attention and Concentration
 Slow Processing Speed
 Automaticity of lower-level skills
   Automaticity of producing alphabet
    letters
   Automaticity of spelling (knowing
    patterns)
   Poor fine-motor/handwriting ability
         Output Controls Necessary for Writing
                                 Dr. Mel Levine
                   University of North Carolina Medical School
     Director of Clinical Center for the Study of Development and Learning


                                   Option Controls               Pace Control
   Quality Control
                                 Making Decisions and             Processing
Evaluating and Using
                                   Choosing Best                    Speed
     Feedback
                                      Alternative
                                                                 Too Slow vs.
                                                                   Rushing

                             Output Controls
                           Monitoring and Regulating




   Previewing/Planning Control
                                                           Reinforcement Control
           What are the
                                                          Learning from Previous
          Requirements?
                                                                Experience
            (blueprint)
Diagnostic Assessment of Writing


                      Current Achievement Measures




Lower Level Processing Skills              Educational/Instructional Program




                       Executive Function/Attention
       Assessment of Writing
    Lower Level Processing Skills
      Orthographic Awareness
 The ability to hold words, letter
  groups, and letters in memory -the
  ability to “image” words in the mind

   Writing words and nonwords viewed
    briefly (1 second)

   Reading words and nonwords viewed
    briefly (1 second)
glitter
a
physical
a
fracagen
3rd and 4th letters
         Lower Level Skills
       Phonological Awareness
Hearing the sounds that make up words

Understanding that “CAT” is made up of the
  individual speech sounds “C-A-T”

 Say “string”
 Now say it without the “st”

 Say “sprite”
 Now say it without the “p”
         Lower Level Skills
        Phonological Memory
 Repetition of nonsense words
   The ability to hold in mind the sounds
    within words

   Important spelling multi-syllabic words

   Poor phonological memory - forget the
    beginning of word by the time the end
    has been decoded
Lower Level Skills
Language Processing Measures
 Formulated Sentences (semantics)
   Viewing a picture and making up a sentence
    about it using particular required words
   Measures language skills


 Word Fluency
   Write all the words that you can think of that are
    round
   Measures access to words from “mental
    dictionary”
   Rapid Automatized Naming
             (RAN)
 The ability to quickly read letters,
  words, numbers.

 A measure of the access to “name
  codes” – fluency of language

 Related to reading fluency, processing
  speed
S   X C G H K S B E   W F S
L   U T B C E A Q K   L   R V
H T   B P T D X Z G   B E   F
K J   R G C M U X G   E S   L
P U V D S Q A Z   J   F A T
R L K V   E G M O Q   P D A
           Lower Level Skills
         Handwriting Measures
 Related Fine Motor Processes
   Finger repetition
   Finger succession
   Finger localization


 Automatic retrieval and production of
  ordered alphabet letters

 Copying Written text (speed and fluency)
           Achievement Measures
   Composing
     Sentences and Paragraphs – quality

   Writing Speed and Fluency Measures
     Writing simple sentences quickly

   Spelling
     Real Words
     Pseudowords (made-up words that follow regular spelling
       patterns)
          brangle, snirk, psychomation

   Vocabulary Development

   Mechanics
                  Cognitive Processing
                                          Cognitive
                                          Processes




Verbal Comprehension     Working Memory          Processing Speed       Perceptual Reasoning




                                                 Speed of Information
 Vocabulary Knowledge   Holding Events in Mind                           Visual Spatial Ability
                                                     Processing
    Comprehension        “Mental Scratchpad”                             Nonverbal Reasoning
                                                    Output Speed
        Attention/Executive Function
   Cognitive Assessment (IQ)
     Processing Speed
     Working Memory

   Behavioral Checklists
     Parent
     Teacher
     Self-Report

   Neuropsychological Assessment
     Planning/Organizing/Impulsivity/Attention

   Observation
     Classroom
     Testing
Educational/Instructional Assessment
 Classroom Observation

 Records Review

 Curriculum Review

 Teacher Interview
   School Assessment for Special
        Education Services
 School assessment focuses on qualification
  for services using the “severe discrepancy
  model”.

 School assessment is not designed to be
  diagnostic.

 A child can have a significant learning
  disability and not qualify for special
  education services.
    What is a Specific Learning Disability?
    Definition From the Individuals With
            Disabilities Act (IDEA)
      Specific Learning Disability:
     A disorder in one or more of the basic
      psychological processes involved in
      understanding or in using language spoken
      or written, which may manifest itself in an
      imperfect ability to listen, speak, read,
      write, spell, or do mathematical calculations

     Does not include problems resulting from visual,
      hearing, or motor handicaps, mental retardation,
      emotional disturbance, or environmental,
      cultural, or economic disadvantage. (1967, 1975
      Federal Guidelines)
      How Do Children Qualify for
              Services?

 Current guidelines use a" discrepancy formula” to
  determine the presence of a “Specific Learning
  Disability” (SLD)

 Severe discrepancy between ability (as measured
  by IQ) and achievement (as measured by current
  academic achievement testing)

 If there is not a significant difference between
  predicted scores based on IQ, then it is assumed
  that the child is performing at the “expected level”
  and does not meet criteria for services.
Why the Discrepancy Formula is
           Wrong:
   The “Wait to Fail Model”

 Every state uses a different
  discrepancy formula – different
  criteria, different assessments

 There is no scientific evidence of
  intrinsic differences between
  children with achievement
  discrepancy and children without
  achievement discrepancy. Both
  groups make gains with
  treatment.
Comparison of Reading Disabled Children With
and Without IQ-Achievement Discrepancy




                              9
 Why the Discrepancy Formula is Wrong:
        The “Wait to Fail Model”

 Using a discrepancy model interferes with the early
  identification of learning disabilities. Poor academic
  performance cannot be reliably measured until grade
  3, creating a “wait to fail” model. Children need to get
  bad enough to qualify for services. Often, these
  students never catch up.

 Current federal guidelines exclude services to children
  due to environment, inadequate teaching, cultural,
  and economic disadvantage, the very children who
  need services!
Demise of the Severe Discrepancy
            Formula
 The Congress has passed a bill that
  will end the federal law requiring a
  discrepancy formula in May, 2005,
  after more than 25 years!!!
 New models will need to be set up:
   Early Intervention
   Three-Tiered Model
   Response to Intervention
          Intervention


Best Practices in Treating Writing
            Problems
Be Wary Of…..
 Unsolicited assessments or screenings by people
  offering “free screenings” for learning problems, and
  then recommending their type of intervention.

 Alternative and unproven therapies that propose to
  “cure” learning disabilities. There is no “cure” for
  learning disabilities, per se.

 Assessment that is not directly related to the specific
  academic deficit. Scientific research does not
  demonstrate the efficacy of “crossed dominance
  theory”, “learning style”, “eye tracking exercises and
  colored lenses”, or “sensory integration” as
  interventions for reading, writing, spelling, or math
  disabilities.
               Intervention
               What Works
 Handwriting Automaticity Training
   PAL Guides
   Big Strokes for Little Folks
PAL Writing Lessons
PAL Talking Letters Desk Guide
                Spelling
 Marsha Henry’s Words Program
   Word Structure Analysis
     Greek and Latin Roots/Morphology

 How To Teach Spelling

 PAL Talking Letters

 PAL Orthographic Awareness Training
Executive Function Approach to Writing:
Self-Regulated Strategy Development
(SRSD) Graham and Harris

 Developed 15 years ago

 Belief that every child can write

 Teaches specific strategies for
     Planning
     Writing
     Revising
     Editing
Self-Regulated Strategy
Development (SRSD)
 Goal Setting
   What is required?
 Self-instructions
   “self-talk” - modeled by teacher
 Self-monitoring
   checking for accuracy
 Self-assessment
   Did I meet my goals?
 Self-reinforcement
   Making the work meaningful
Example of an SRSD Strategy
from Graham and Harris “Making the Writing
Process Work”

 Three-Step Planning
1. Think-who will read this?
     Why am I writing this?
2. Plan what to say – Use S-P-A-C-E
     Setting
     Purpose
     Action
     Conclusion
     Emotions
3. Write and Say More
   Other Cognitive Strategies for
             Writing
 Mnemonic Strategies for Theme
  Writing
   TOWER
     Think of Ideas
     Order Ideas
     Write Ideas – connected paragraphs
     Error Monitor (organization, sentence
      structure, minor errors)
     Recopy (for neatness, format)
   Other Cognitive Strategies for
             Writing
 Mnemonic Strategy for Error
  Correction – COPS

     Capitalization
     Overall Appearance
     Punctuation
     Spelling
      Assistive Technologies
 Voice Recognition Computer Software
   Dragon Naturally Speaking
 Mind-Mapping Computer Software
   Inspiration, KidSpiration
 Keyboarding
   Alphasmart
  504 or IEP Recommendations and
          Accommodations
 Classroom
     Tape recording class lectures
     Algorithms for checking work on desktop
     Not having writing corrected by classmate
     Extra time on written tests including SAT, WASL
     Oral tests instead of written tests
     Pre-written class lecture notes
     Alpha-Smart or laptop computer
     Scribe
Academic Accommodations and
     Recommendations
 Homework:
   Voice recognition or mind-mapping software
   Shorter assignments/assignments broken down into
    shorter sections with intermediate due dates
   Not counting mechanical/spelling errors

 Handwriting:
   Pencil grips
   PAL handwriting lessons (primary grade students) or
     explicit handwriting instruction
   Eliminate requirements for cursive writing
   In math, using graph paper to line up numbers
               Homework Tips
 Encourage your writer to map out ideas (prewriting
  strategies)
   There are software programs to help such as
      Kidspiration and Inspiration
 Provide a homework area that is well organized at a
  table or desk and not on a bed.
 Reinforce that the first writing attempt is a draft.
  Writing is a mult-step process.
 Develop strategies to help your child to self-monitor
  their work. In partnership with your child, develop a
  writing process checklist.
University of Washington
  Learning Disabilities
    Center “Mantra”
Imagine ALL the children learning well
   in school
 .
You may say we are dreamers
But then we are not the only ones
We hope you will join us and
The world will be a better place

								
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