the presentation Slide Deficit by mikeholy

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									          Dyslexia:
    Your Questions Answered

       Dyslexia as understood in a
Neuro-developmental Model of Assessment
            and Interventions



                                          1
                   Agenda

   Housekeeping

   Introduction of Lexicon Team

   Presentation

   Discussion



                                   2
             Introduction Lexicon Team
Rudolf Stockling
MSc (Psych) MAPS Registered Psychologist NSW Australia
Educational Psychologist
Director of Assessment Lexicon Reading Centre

Praveen Vasanthakumari
MSc (Psych), Sp. Ed., Education Therapist
Learning Specialist

Saloni Krishnan
MSc Cognitive Sciences BASLP
Communication and Speech and Language Therapist

Rania Anis Bin Taleb
MSc SPM PMI Member
Managing Director


                                 www.lexiconreadingcenter.org



                                                                3
              Presentation Outline
1.The   Neuro-developmental Model:
           Recap
2.Dyslexia:   What is it ?
              Scientific Theories of Dyslexia
3.Dyslexia:   Who has it ?
              Characteristics of Dyslexia
4.Dyslexia:   What to do about It ?
           A) Assessment b) Interventions
5. Discussion
                                                4
       1. Neuro-developmental Model
   Eight Constructs
   ���� Attention
   ���� Higher Order Cognition
   ���� Language
   ���� Memory
   ���� Neuro-motor Function
   ���� Social Cognition
   ���� Spatial Ordering
   ���� Temporal-Sequential Ordering

                                      5
                     Attention Control
 Social
thinking
                                                Memory

                          The
 Higher             Neurodevelopment
 Order                  Systems                     Language
Thinking


           Neuro-                        Spatial Order
           Motor
                      Sequential
                      Ordering



                                                               6
2. Dyslexia: What is it ?
    Scientific Theories of Dyslexia




                                      7
I saw a red surfbord laying on the rode. It
look like my friend so I hid it in the bushis
just in case. When I whent to the beach I
saw my frend Spence he had his bord….




                                                8
Visual problems in reading




                             9
                 Definition of the
        International Dyslexia Association
Dyslexia is a specific learning disability that is neurological
   in origin.
It is characterized by
 difficulties with accurate and/or fluent word recognition
   and by poor spelling and decoding abilities.
 These difficulties typically result from a deficit in the
   phonological component of language that is often
 unexpected in relation to other cognitive abilities and the
   provision of effective classroom instruction.


                                                            10
    How Widespread is Dyslexia?
                                               Likely to
                               % w/ reading   be dyslexic
                                disability


   Current research shows that
    approximately 15-20% of the
    population has a reading              School
    disability.                         population



   Of that 15-20%, 85% are dyslexic

                                                     11
            Neural Basis of Reading
   Left inferior frontal
    gyrus
   Left temporo-parietal   Speech   Alphabetic code
                            sounds
    cortex
   Left infero-temporal                   Visual word
                                           form
    cortex



                                                 12
Dyslexia




       Brain Briefings, Society for   13
       Neuroscience
 Major Current Dyslexia: Theories

1.Phonological Deficit Hypothesis

2.Double Deficit Hypothesis

3.Automaticity Deficit Hypothesis

4.Cerebellar Deficit Hypothesis



                                    14
   1. The Phonological Deficit Hypothesis

Cause of Reading difficulties is in
phonological processing such as
problems in
• sound segmentation
        and
• in   word blending
both are critical for the development of
 reading and spelling.                      15
         2. The Double Deficit Hypothesis

Two crucial deficits:

   (i) Phonological processing problems

   (ii) Rapid processing problems
    (naming speed, comparing same different speed)



                                                 16
    3. The Automatization Deficit Hypothesis

   The concept of an ‗automatization deficit‘
    explains the range of problems shown by
    dyslexic children.
   Dyslexic children will have difficulties on any
    task that requires automatisation of skill.
   Even on task where they appear to be
    performing normally they have to try harder to
    achieve the same results.

                                                      17
    2. The Cerebellar Deficit Hypothesis


 Cerebellum may be an underlying causal
  factor for all the characteristics explained
  by the other theories
 Cerebellum has many functions such as
  balance, motor control etc.


                                                 18
Cerebellum




             19
    The role of the cerebellum in dyslexia
   It‘s role in making processes automatic relates to
    the difficulty experienced for Dyslexic people to
    become fluent readers.

    Why specific to reading?
    Severe problems arise for reading and spelling,
      because they require both good phonological
      skills and good automatisation - double
      difficulty!
                                                         20
                   Questions


   How different are these theories?

   Is this like the four men and the elephant?




                                                  21
Six Blind Men




                22
                 Effect Size




-10
       -9
            -8
                 -7
                      -6
                           -5
                                -4
                                     -3
                                          -2
                                               -1
                                                    0
                                                        1
                                                        Balance Dual
                                                        Spelling Age
                                                        Reading Age
                                                        Segmentation
                                                        Bal. 1 ft Blindfold
                                                        Balance 1 Foot
                                                        Nonword Repetition
                                                        Letter Naming
                                                        Picture Naming
                                                        Lexical decision
                                                        Articulation Time
                                                        Balance
                                                        Colour Naming
                                                        Selective CRT
                                                        Digit Naming




      Speed
                                                        Phon. Discrimination
                                                                                              children




      Balance
                                                        Visual Search


      Motor Skill
      Phonological                                      Pegboard
      Psychometric

                                                        Rhyme
                                                        Bal. 2 ft. Blindfold
                                                        Beads
                                                        Memory Span
                                                        Performance IQ
                                                        Simple Reaction Time
                                                        Balance 2 Foot
                                                        IQ
                                                        Verbal IQ
                                                                               Difficulties experienced by dyslexic




  23
                       Answers
Answer:
  (i) Different theories are at different levels of
     explanation

   (ii) The type of explanation that is most valuable
      depends upon the question you are asking!

   (iii) It may be that different dyslexic children suffer
      from different underlying causes.

                                                             24
      Why Are many Dyslexic Children
                Clever?!
   The cerebellum is needed for unconscious
    development of skill fluency. Skills can be
    acquired without the cerebellum .
   The traditional seat of intellectual behaviour, the
    frontal lobes of the cortex, may well be
    completely spared, or even over-achieving.
    IQ, metacognition, strategy use, knowledge etc.
    are all fine.
   Dyslexia is not related to Intelligence

                                                     25
             3. Dyslexia: Who has it ?
   Characteristics of Dyslexia

   How do we recognize a child with dyslexia




                                                26
27
                  2-D learners
   Have talent for language

   Good at sequence and time and events

   Memory for abstract symbols—letters stand for
    something




                                                    28
              3-D learners
Have a talent to make, do, draw, build
Often intuitive, creative, and good imagination
May take up to 1500 repetitions of seeing a
 word or letter to remember it
Do not do well with idioms
     ―knock it off‖
  Often seen as lazy or immature


                                                  29
Not a Single Pattern that Identifies a
       Student with Dyslexia
   Some
     Reverse letters—others do not
     Show related problems with spoken language—
      others do not
     Have problems with attention—others do not

     Have trouble retrieving words to recall them
      quickly—others do not
     Have trouble with math—others are talented in
      math

                                                  30
Some
  Have problems with organization—others do
   not
  Appear insensitive to others—others are very
   sensitive
  Have a low self-esteem—others do not

  Have difficulty with handwriting—others do not

  Have a slow rate of writing—others do not




                                                31
      A Student with Dyslexia has a Unique
      Pattern Much Like Your Fingerprint
   Person who reads well with poor Comprehension
   Inaccurate reader with ok comprehension
   Extremely slow reader
   Strong speller and the slow reader
   Adequate reader who has difficulty with all written
    expression including copying and spelling
   One that has trouble with all of the above

                                                          32
        Activity 1: Signs of Dyslexia
   1. Participants describe to each other a child
    they know who has been diagnosed with
    Dyslexia
   2. Group discusses the age appropriate warning
    signs described in the handout
   3. Add any other signs that you have observed
   4. One member reports to all participants


                                                     33
       Warning Signs in Preschool
   Delayed speech; slow to add new words;
    difficulty finding the right word
   Mixing up sounds or syllables in long words
   Poor memory for nursery rhymes
   Difficulty learning colours, days of week,
    numbers, shapes
   Difficulty learning how to spell or write name



                                                     34
            Warning Signs in K-3
Difficulty understanding
 that words can be separated into parts
  (firetruck: fire and truck)
 that words can be separated into sounds (tip =
  /t/ /ĭ/ /p/)
 Difficulty learning letter names and sounds
 Difficulty reading single words; relies on
  context clues to recognize words; Can’t
  remember sight words
 Slow choppy, inaccurate oral reading
 Difficulty with daily spelling               35
Warning Signs Grades 4th – High School

   Has difficulty spelling – may use simplified
    vocabulary when writing.
   Continues to have reading difficulty
   Lacks fluency; reads slowly; avoids oral reading
   Avoids reading for pleasure
   Difficulty finding the right word when speaking
   Dreads going to school

                                                       36
Effects of dyslexia reach far beyond
            the classroom
  Self-image

  Feelings  of being dumb or ―different‖
  Feeling of being less capable than they
   really are
  Stress due to academic or social problems

  Discouraged about continuing in school




                                               37
          Important to remember that

   students with dyslexia can learn
     They just learn in a different way
     Not a disease or result of an accident or injury
      but rather it describes a kind of mind
        Often gifted and productive mind that learns
         differently




                                                         38
                4. Dyslexia
            What to do about it ?


   Assessment of Dyslexia




                                    39
                    What do consider
   Possible other issues / co morbidities
       Cognitive Ability (Gifted / Slow Learner)
       (Language / Non-verbal Issues
       Psychological issues (ADHD / Anxiety Motivation / Self
        Esteem / Family Issues)
   A thorough assessment is essential to determine the
    exact nature of the learning difference and to exclude
    alternative explanations for the problem

   A diagnosis leads to a remediation plan
        and
   recommendations for interventions

                                                                 40
              Assessment Steps
   Referral
   Data Gathering
   Testing
    Psychological Issues
    Ability (Language, Perceptual, Memory, Processing)

    Achievement (Reading / Maths / Listening /     Oral
    Language)
    Reading / Writing Behaviour

   Intervention Plan Formulation
                                                       41
        Data Gathering Informants
   Information about the student
     • Student‘s work samples, Test Results Reports



    •   Teacher‘s observations (Interview,
        Questionnaires, Informal)

    •   Parent (Interview, Questionnaires)


                                                      42
        Areas of Data Gathering

   Vision/hearing                Samples of school work
   Teacher reports               Parent conferences
   Previous assessments          Speech/language
   Accommodations/                (previous referrals)
    Modifications (classroom      OT, other interventions
    teacher)
   Academic progress
    reports

                                                             43
          Assessment Instruments
   Have to be valid
   Culturally appropriate
   Assess the specific areas of educational need;
    not to provide a single general IQ
   Have to accurately reflect student‘s aptitude,
    achievement level and specific learning
    profile


                                                     44
     Assessment of General Issues
   Psychological Questionnaires (Parents /
    Teachers / Students) (Achenbach System of
    Empirically Based Assessment ASEBA)
   Learning Style (Parents / Teachers / Students)
    Cognitive Processing Inventory (CPI)
   Ability Wechsler Intelligence Scales (WISC-
    IV, WPPSI-III)
   Achievement (Wechsler Individual Achievement
    Test WIAT-II)
   Others depending on need
                                                     45
    Literacy Specific Assessment
            Instruments
   Reading single words in isolation
       Wide Range Achievement Test 3 (WRAT-3)
       WIAT-II Word Reading
   Word Decoding
       WIAT-II Pseudoword Decoding
   Phonological Awareness
       Phonological Awareness Test (PAT)




                                                 46
   Letter Knowledge
       WIAT-II Word Reading
   Fluency / Rate and Accuracy:
       WIAT-II Reading Fluency
   Reading Comprehension:
       WIAT-II Reading Comprehension
   Spelling:
       WIAT-II Spelling
   Orthographic Encoding / Decoding --
    Phonetic Reading Chain Diagnostic   Reading
    Assessment

                                                  47
         Differential Diagnosis
Good evidence for three forms of disability
in reading that
       co-occur and

       occur in isolation

1. Word recognition

2. Comprehension

3. Fluency



                                              48
         Activity 2 : CASE STUDIES
   Each Group receives the assessment profile of a
    child.

   Look at the assessment profile and discuss if
    that child could be diagnosed with Dyslexia.

   We do first Case Study together


                                                    49
      SS Standard Scores Distribution
   Very Superior Range   >130       2.2 % of Students
   Superior Range        120-130    6.7 % of Students
   High Average Range    110-120   16.1.% of Students
   Average Range          90-110     50.% of Students
   Low Average Range      80-90     16.1.% of Students
   Borderline Range      70-80       6.7 % of Students
   Extremely Low         <70        2.2 % of Students



                                                     50
    Case Study 1: Rania/ Year 5
WISC-IV Full Scale IQ      Average

WIAT-II:
   Listening Comprehension         105
   Word Reading:                   77
   Reading Comprehension           77
   Pseudoword Reading              67
   Spelling                        83

  Alphabet:       No difficulty
                                         Dyslexic?
  Consonant sounds:        19/21
  Short-vowel sounds:      1/5
                                           Yes / No
  Phonological Awareness: 85
  Phonological Memory:    103
  Rapid Naming:              91

                                                      51
           Case study: Praveen Year 4
WISC-IV FSIQ          Average Range
WIAT-II:
           Word Reading:              73
           Reading Comprehension 98
           Listening Comprehension: 104
           Pseudoword Reading         89
           Spelling                   75
           Phonological Awareness: 85
                                           Dyslexic?
           Phonological Memory: 97
           Rapid Naming:              76
                                           Yes / No
       Alphabet: no difficulty
       Consonant sounds: 19/21
       Short-vowel sounds: 4/5
                                                       52
               Case study: Rudy Year 5
WISC-IV FSIQ          Low Average Range
WIAT-II:
           Listening Comprehension 96
           Word Reading:             103
           Reading Comprehension 118
           Pseudoword Reading        101
           Spelling                  102
   Phonological Awareness: 100             Dyslexic?
   Phonological Memory:     88
   Rapid Naming:            88
                                            Yes / No
   Alphabet: no difficulty
   Consonant sounds: 20/21
   Short-vowel sounds: 2/5
                                                       53
           Case study: Saloni Year 5
WISC-IV           Borderline Range
WIAT-II:
  Reading Comprehension                   86
  Word Reading                            78
  Pseudoword Decoding                     82
  Spelling                                80

 Alphabet: unable to recite or write
 Naming lower case letter:        25/26        Dyslexic?
 Consonant sounds:        18/21
 Short-vowel sounds: 5/5                       Yes / No
Phonological Awareness:      73
Phonological Memory:         76

                                                           54
           IMPORTANT
Tests Do Not Evaluate, they give Information

           People Do Evaluate




                                               55
         4. What to do about it ?

   B Interventions




                                    56
                Reading Rope
   LANGUAGE COMPREHENSION
  ● Background Knowledge
  ● Vocabulary Knowledge
  ● Language Structures                                              SKILLED READING:
  ● Verbal Reasoning                                                 fluent execution and
  ● Literacy Knowledge                                               coordination of word
                                                                     recognition and text
                                                                     comprehension.




   WORD RECOGNITION
 ● Phonological Awareness
 ● Decoding (and Spelling)
 ● Sight Recognition


Reading is a multifaceted skill, gradually acquired over years of instruction and practice.
                                                                                      57 54
                                                                                       p.
        Principles of Interventions
   Based on thorough Assessment and knowledge of
    learner
   Measurable goals developed after assessment
   Identifies strengths
   Determines the skill deficits to be addressed
   Uses preferred learning modalities
   Active participation of learner
   Strategy based on the above
                                                    58
     Major Intervention Strategies

   A Multisensory Instruction

   B Guided Discovery

   C Mastery Learning



                                     59
    A Multisensory Teaching
Uses the Four Pathways of Learning

   Auditory

   Visual

   Kinaesthetic

   Tactile
                                     60
61
Multisensory Teaching


  Simultaneous and alternative deployment
  of visual, auditory, kinaesthetic, and tactile
  sensory modalities that supports the
  connection of oral language with visual
  language symbols



                                                   62
    Multisensory Teaching

Example: /k/ = ck

  Discovering a new letter-sound association by
  listening to words with the same sound in the final
  position while looking at the mouth in a mirror
  feeling how it‘s made, seeing a list of the words
  and writing the new digraph.


                                                        63
   It is a systematic step-
    by-step approach,
    proceeding from the
    simpler to the more
    complex in orderly
    progression in an
    upward spiral of
    language development.


                               64
           What is Taught?
 Phoneme and Phonological Awareness
 Sound-Symbol Association

 Syllable Instruction

 Morphology

 Syntax

 Semantics




                                       65
 Using Multisensory Strategies
                Auditory
•Discriminate number of sounds in spoken words
•Say key word and sound
•Segment spoken word into syllables
•Listen for base words, roots and affixes
•Paraphrase sentences accurately




                                                 66
    Using Multisensory Strategies

                   VISUAL
* Look at mouth to see mouth position
* Look at card with letter and key word
* Look at printed word to identify vowel sounds
  and number of syllables
* Identify base words, prefixes and suffixes



                                                  67
Using Multisensory Strategies
         Tactile
•Feel voicing airflow /th/
•Form letters with play dough
Write in sand tray
•Feel sandpaper letters and words


                                    68
  Using Multisensory Strategies

         Kinaesthetic
•Arrange letters in alphabetical order
•Use tokens to segment sounds in spoken
  words
•Feel movement of articulatory muscles
  when phonemes are spoken
•Build words with syllable cards

                                          69
      LESSON PLAN FORMAT

   Alphabet/Phonemic Awareness
   Letter Sounds Review
   Spelling Sounds
   Discovery of Linguistic Concept
   Handwriting
   Reading Practice
   Spelling Practice
   Review of Today‘s New Learning
   Extended Reading/Writing
   Listening/Comprehension

                                      70
     Activity 3: Multisensory teaching
     Task: Teaching consonant blends
1.    Demonstration
2.    Group teaching of blends ‘sl’, ‘br’, ‘tw’ and ‘sm’
3.    Visual: Presenting blend printed on flash card.
4.    Auditory: Say the name of the blend ,say the key word of the
      picture & then the sound of the blend.
     Student repeats the key word and the sound of the blend.
     Teacher says sound and student repeats
5.    Kinaesthetic: Student writes the blend, copying from the
      model, saying name as he/she writes it.
     Student writes it from memory, reads what has been written and
      giving the sound.
     Student writes blend with eyes closed – to enhance kinesthetic
      feed back.
6.    Tactile: Form the blend with play dough while saying it


                                                                       71
              B Guided Discovery
   Guided discovery involves the student‘s
    pathways of learning.
       (Auditory/Visual/Kinaesthetic/Tactile)

   Socratic questioning or ―guided questioning‖ is
    leading students to the answers without telling
    them.

   Because of the memory systems and the need
    to stimulate multiple modalities, the
    ―discovery‖ approach to instruction is effective
    with dyslexic students.
                                                       72
           Auditory Discovery

   Uses questioning techniques for auditory
    discovery,
   linking the new to the known, and
   building on similarities or differences.

        What   do you hear that is the same?



                                                73
               Visual Discovery
After auditory discovery,

the visual symbols representing the new concept
  or phoneme are presented

using questioning techniques to lead students to
  self-discovery.
      What   do you see that is the same?

                                                   74
    Kinaesthetic / Tactile Discovery

Skywriting / Walking Shapes/ Play dough
   creation of symbols
 Are some of the techniques used in

   kinaesthetic-tactile discovery
   Make, Trace & Copy letter shapes
   Workbook
   Spelling Notebook

                                          75
   Elements of Discovery Learning
                            Brain Power
     Develops natural
                                          Links new with old
     curiosity to learn
                                              knowledge


Holds interest                                             Develops
   Active                 Discovery Learning               ability to
 participate                                               retrieve
responsibility                                           information



                    Strengthens           Develops
                   knowledge of           decision-
                   relationships         making skills
                 between concepts

                                                                        76
    C Mastery Model of Teaching and
               Learning

   Uses the Following:
     Prior Knowledge

     New Learning

     Review

     Practice

     MASTERY



                                      77
                   Mastery Model of
                  Teaching & Learning
           feelings      ideas

concepts
              Prior              memories
            Knowledge

  motivations
                  experiences

                                            New Learning


                                              cumulative
                         Review              Short term memory
                                                                 Practice
                                              automaticity

                                               Mastery
                                                95%
                                                                            78
Introduce

 Review

Practice

            79
       Mastery Model Teaching
   Simultaneous Multisensory Instruction
   Guided Discovery
   Intense Instruction/Consistent Practice
   Systematic and Cumulative
   Synthetic and Analytic
      Synthetic: how letters come together to

       form a word
      Analytic: breaking a word into smaller parts



                                                      80
   Periodic measures of progress
     Bench Mark Measures determine progress at each
      level of training
     Assures teacher that student‘s knowledge is secure
      before advancing to next level
     Success on each measure serves as motivational
      incentive for student while encouraging self-
      confidence
     New learning based on well-established concepts to
      enable student to integrate skills systematically,
      successfully, and permanently


                                                           81
                Conclusion:
       Effective Scientific Instruction
individualized
multidisciplinary
multisensory
synthetic-analytic
Systematic
Cumulative
Communicative

                                          82
   If instruction is planned to meet the
    differing needs of learners, it is
    individualized.
   If instruction is based on the knowledge
    and skill of experts from many fields,
    including education, psychology, and
    language theory we call it
    multidisciplinary.

                                               83
   If the sounds of the letters can be blended into
    words for reading, and the words can be divided
    into the sounds they are made of for spelling and
    writing then we call the process
    synthetic-analytic.
   If instruction simultaneously uses the
    learning pathways of visual (seeing),
    auditory (hearing), and kinaesthetic
    (movement), tactile (touch)
    then it is multisensory.

                                                        84
   Material is organized and taught in a way that
    is logical and fits the nature of our language.
    The procedure is systematic.
   The learner moves, step by step, in order,
    from simple, well-learned material to that
    which is more and more complex, as he or she
    masters the necessary body of language skills.
    The teaching is sequential.
   Each step of the way is based on those already
    learned. The process is cumulative.

                                                      85
The  ultimate goal is for a student to understand
the reasons for what he is learning so that he can
think his way through language problems. The
purpose of it all, from recognizing a letter to
writing a poem, is getting meaning from one
person‘s mind to another‘s. Communication is
paramount.



                                                 86
                   GOOD NEWS!!!!
   Good news is that students with dyslexia can be helped
    to cope with their difficulties if their learning profile is
    scientifically diagnosed and if they are taught on
    evidence based methodologies
   using multisensory teaching methods, within a
    discovery learning framework to mastery level of each
    skill

   they can learn to read and write to a level appropriate to
    their general ability.

                                                                   87
   Perhaps most important of all, with the
    understanding, support, and encouragement
    of parents and teachers they can avoid the
    hurt and burden of failure and frustration that
    affects their lives.



                                                      88

								
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