Join Dr. Blanche Podhajski as she helps parents and teachers unravel and understand the important questions about the evaluation process such as timing, what the proposed tests measure and what the outcomes mean when a comprehensive evaluation is conducted.
Transcript
Joanne Boucher Currently, I service many students with LLD. Have you found any evaluations that assess higher level thinking? Are there students with LLD who exhibit deficits only in this area, with minor deficits in other areas, such as semantics or processing texts?
Criteria in our district do not provide for services for individuals with deficits in higher level thinking, only if the student demonstrates a "significant" disability in language (usual assessments given: CELF, OWLS, TOLD, TAPS, WORD). Many of my students (who I qualify) are being considered ineligible because of test scores, but their performance in the academic setting is well below par (with many failing). There is also a developing pattern to dismiss students by 5th grade saying they will always be that way and there is not much more we can do to have a signifcant impact. Your thoughts? Thank you.
Blanche Podhajski Ph.D.
Thank YOU for thinking outside the box on behalf of our students, not giving up on them and NOT being limited by scores. Absolutely we have learners who do not experience difficulties until language becomes more abstract or requires more mental manipulation.
I also do not find our language tests to be sufficiently refined to help us help these students. To begin, I would suggest that you demonstrate whether the higher order thinking skills affected are only verbal. If WISC-III nonverbal subtests such as Block Design and Matrix Reasoning are strong, the problem is not a generalized thinking problem but one specific to language and for which intervention is critical. We see many medical students at the Stern Center who have managed by virtue of their outstanding intelligence to get by through college, but hit the wall when they cannot manage all the verbal information they have to flexibly deal with in med school. I like to do diagnostic teaching with these learners to see how they categorize and classify verbal information. If nonverbal skills are strong, software programs such as Inspiration can be of help to them. If the thinking skills occur across both verbal and nonverbal domains, you are dealing with a different kind of learner.
You might also want to look at the BRIEF, the Behavior Rating Inventory of Executive Function. It consists of observations completed by parents and teachers that can help tease out behaviors suggestive of thinking skill differences.
Jackie Scott What are some of the key indicators to diagnosing a learning disability? Does flat affect and intonation coupled with weaker reasoning, avoidance of reading (despite being able to read) help you understand how to diagnose a student?
Blanche Podhajski Ph.D.
In addition to an unexplained disparity between intelligence and performance on academic tasks such as reading despite good instruction, there are core cognitive processes that may contribute to learning disabilities and which need to be assessed. These include phonological awareness and rapid automatic naming.
Some of the behaviors you describe may be more suggestive of difficulties with social language and understanding - I would recommend further examination of pragmatics and social skills.
Kim McClain In what instances is an Independent Educational Evaluation helpful? Can the District refuse it?
Blanche Podhajski Ph.D.
An Independent Educational Evaluation can be a very helpful tool for both parents and schools, particularly when parents disagree with the conclusion of the initial evaluation. An Independent Evaluation can offer a different opinion or concur with the original conclusion. Either outcome offers the child the opportunity for the best diagnosis and intervention.
jen m Do you think a private neuropsycholigical or psycho educational evaluation is a a better way of gaining insight to the unique learning aspects of a child?
Blanche Podhajski Ph.D.
It is not WHERE the evaluation takes place that is as important as WHO does WHAT and WHY the evaluation is needed. For example, if the referral question relates to why the child is not responding to a particular kind of reading intervention and what is the best way to teach her, not all neuropsychologists may be familiar with the subtleties of different kinds of research based reading instruction. Some neuropsychologists may have this kind of knowledge.
Usually, a neuropsychological evaluation is helpful when more in depth understanding of brain behavior relationships is desired. For example, are there underlying problems with memory and attention or are there significant medical or developmental history questions related to prematurity, traumatic brain injury or a seizure disorder.
A good neuropsychologist can help direct students how to learn using their strengths but not necessarily using a specific educational curriculum. It really depends on the training and skills of the evaluator combined with the reasons and needs for the evaluation.
Katherine Andrews My son's evaluation noted that he was dyslexic as well as had a reading and writing disorder. My son's public school told me that the Board doesn't recogize Dyslexia as a diability. How should I approach this?
Blanche Podhajski Ph.D. Dyslexia is a specific kind of learning disability. If school personnel have made your son eligible for special education in the area of reading and writing, that is fine provided the instruction being delivered is systematic, direct and explicit in the areas identified by research as key to reading success: phonemic awareness, phonics, fluency, vocabulary and comprehension. Among dyslexic students, the first three are usually most in need of intervention and application across the curriuculum.
Genie Taylor What if re-evaluation and transitional meetings are not discussed in high school? This is a big deal for those students who met the criteria and are able to go on to higher learning.
Blanche Podhajski Ph.D. This would be a time when seeking a private evaluation would be worthwhile. Many programs like the Stern Center have scholarship dollars available to help underwrite costs for eligible families. You are absolutely correct - it is important for students be as prepared as possible for success beyond high school.
Vivian Manganaro My child has been diagnosed with a Language Disorder. Is this also considered a Learning Disability that the school needs to address? My school's evaluator left out the discrepancy comparison from the CELF-4 that would have determined the Language Disorder.
Blanche Podhajski Ph.D. It would have been helpful to know the discrepancy between your child's ability scores and language score as well as his/her age. Usually, language disorders manifest as learning disabilities in listening comprehension and oral expression if thinking skills are significantly stronger.
Because reading and writing are also language skills, over time a language disorder might also present as a learning disability in reading comprehension or written expression. If the language disorder also includes a deficit in phonological processing/articulation, basic decoding and encoding (basic reading skills and spelling) will also be impacted.
Marlene Rappaport Many of our preschoolers (that began receiving services prior to age 3)are labeled "Developmentally Delayed." When children move into Kindergarten (prior to 6th birthday) we can no longer use Developmental Delay as their primary disability. If they no longer require speech and language therapy yet continue to have difficulties learning, what would we need to evaluate and document to move to an LD label?
Blanche Podhajski Ph.D.
The Comprehensive Test of Phonological Processing (CTOPP) is a great tool to help identify potential reading problems. It can also help plan educational interventions. The Test of Early Reading Ability (TERA-3), Test of Early Mathematics Abilities (TEMA-3)and the Test of Early Writing Skills (TEWS-2), all available from Pro-Ed, Inc. are also appropriate for that age.
Brenda Beebe Can the WJ-III and the WIAT be compared in any way to show progress or regression?
Blanche Podhajski Ph.D.
As you probably already know, it is easier to use alternate forms of the same instrument than different tests to measure progress. While both are good instruments, it is the apples v. oranges dilemma. For example, reading comprehension on the WJ-III is assessed using a cloze procedure while on the WIAT it is measured by having the child answer questions after reading connected language. A comparison across these would not tell you much.
I could not find any correlations between the WIAT and the WJ-III. While both may assess "math problem solving" - which offers greater similarity across measures than "reading comprehension" - the specific constructs being measured remain different.
Karen Beatty IDEA 2004 has provided us with an alternative way to identify learning disabilities. So this is my question, Is the ability-achievement discrepancy model for identifying LD obsolete, or is it still being used?
Blanche Podhajski Ph.D.
One of the recommendations made by the Learning Disabilties Roundtable in 2004 was that the ability-achievement discrepancy model not be used for determining eligibility. They further recommended that regular education assume active responsibility for delivery of high-quality instruction, research-based interventions, and prompt identification of individuals at risk while collaborating with special education and related services personnel.
Response to Internvetion (RTI) is a comprehensive mult-tiered delivery model that helps differentiate between "curriculum casualties" - children who do not have learning disabilities but have not learned to read because of ineffective instruction - and those who have learning disabilities that are neurologically based and intrinsic to the individual. As you know, with the reauthorization of IDEA in 2004, schools were given the option to use RTI or a discrepancy model so both are still currently in use. Check with your school disrict and state department of education on RTI efforts. For more information on RTI, visit the RTI Action Network or view NCLD's Parent Advocacy Guide on RTI
Carrie M. Jones How do we assess comprehension?
Blanche Podhajski Ph.D.
What a huge but wonderful question! One of my professional pet peeves is that all too often reading comprehension is assessed in isolation. That you did not qualify "comprehension" suggests that you may be thinking of it in a bigger picture context as it should be even when the presenting problem is not being able to understand what you read. To begin, reading comprehension AND listening comprehension need to assessed and compared.
If Child A is weak understanding what he reads but strong understanding what he hears, that is very different from Child B who is experiencing difficulties across both reading and listening comprehension. Child A may have a problem accessing print (decoding fluently) and thus cannot understand the meaning of text. Reading fluency should be assessed. Child B may have a generalized language disorder that affects the comprehension of both spoken and written language. A complete language assessment should be conducted. One also needs to assess the child's thinking skills, vocabulary, memory and attention since these may impact comprehension. Finally, and particularly with older students, it is important to know what the student's background knowledge is as well as how effective she is at using strategies to facilitate the process of extracting meaning from what she hears or reads.
Madeline McDougal Students are often referred to the Committe for Special Education for initial referrals in my school. How extensive should the evaluations be. Unfortunately, because of time constraints, the educational component is often based on the results of the WIAT-11, plus teacher observations, informal observations, along with a psychological, social history, and sometimes language evaluation.
Blanche Podhajski Ph.D. You bring up one of the biggest concerns about testing. One of the most important things to remember is that eligibility determination and diagnosis of a learning disorder are NOT the same. Because of time constraints, evaluations are often done by different people - the special educator, psychologist, speech language pathologist - who then present standard scores that are compared across separate reports without attention to the total picture and the intersections among data. This is one of the biggest concerns about the discrepancy model. Merely subtracting 1 or 1.5 standard deviations of scores between ability and academic performance in a particularly area may determine whether the child is eligible for special education but will not necessarily identify the cause of the learning problem nor drive instruction.
When it comes to evaluations, there is no substitute for clinical judgment based on a solid understanding of what we have learned through research over the past several decades. A good clinician will be able to analyze performance patterns on tests across cognitive, linguistic, social emotional and academic domains so that the child is not overtested unnecessarily but, at the same time, so that important subskills are not overlooked. For example, if a child has a decoding problem, it is not sufficient to merely assess word identification. Phonemic awareness,rapid automatic naming, reading words that are both phonetic and sight based, spelling and text reading should also be examined to see if there are deficits in these areas that have implications for instruction.
NCLD has an IDEA Guide for parents that includes a chapter on evaluation. One specific resource that may be helpful is: Questions to Ask About Evaluation Plans.
Jayashree C Shanbal How do you explain to the parents of children with LD, about the effect of bilingualism in such children with LD and how do you go about with the assessment for bilingualism in them?
Blanche Podhajski Ph.D.
In terms of assessment, it is important to get a good developmental history for oral and written language in both the child's primary language and English. Were both delayed? I also like to compare vocabulary understanding and usage as well as reading comprehension and writing across both languages. Caution should be taken to assure that intelligence testing is not culturally or linguistically biased.
Given that learning disabilities are neurologically based, I explain to parents that they evident across different languages but are not the result of bilingualism.
Cynthia Johnson Dr. Podhajski,
I am new to the field of learning disorders in children. The Stern Center for Language and Learning sounds like a wonderful place. Do you know if there is a similar center in Colorado?
Blanche Podhajski Ph.D.
Thank you. We at the Stern Center are very proud to be able to serve all kinds of learners, offer professional development to educators and conduct research.
One way to find out about resources in your area is to check out the Resource Locator on the NCLD Web site. There is a program in a neighboring state that works collaboratively with the Stern Center: the Lee David Pesky Learning Center in Boise, Idaho. Perhaps you could visit them. We would also welcome you to Vermont at any time - please put yourself on our mailing list at the Stern Center Web site.
K. Crouse If I see,"Teacher's observation of specific skills" listed on my daughters IEP one more time I swear I'll scream! How can I get more measurable goals listed such as testing rather than this comment?
Blanche Podhajski Ph.D.
With the advent of RTI, we all should be applying the scientific method to the problem solving process. That is what you are asking your child's teacher to do. Explain to school personnel that you are interested in instructional decisions based on data. Informed decisions can't be made without them.
Often, school personnel may not do this because they don't know how. Request data charts that show progress over time. Progress monitoring should include routine ssessment (weekly, monthly or quarterly) using comparable and multiple test forms. If adequate progress is not demonstrated, a different kind of intervention may be needed. If the school do not have staff who feel comfortable with this kind of assessment, suggest independent monitoring by a trained consultant to build capacity.
lidice martinez I want to know if getting an evaluation affects the student in the future -- if they want to get into a good school or get a scholarship?
Blanche Podhajski Ph.D.
Getting an evaluation would not interfere. It could help illuminate strengths and needs for the student interested in pursuing higher education and help prepare him for the experience.
Should the student be identified with a learning disability following evaluation, it would be up to him whether or not to declare that information on a college or scholarship application. While it would be illegal to discriminate against a student on that basis, not all students elect to declare. It is best to find out from particular colleges being considered what their practices are for students with learning disabilities, what services they offer and how best to advocate in one's own behalf.
Cali Nichols What is the best way to evaluate writing skills. It seems like such a subjective process the way my school does it now with just counting the number of words written and whether there is punctuation. Now, if my child just writes more words on a page than he did in first grade then he is "progressing".
Blanche Podhajski Ph.D.
I always say that writing is the last bastion to be conquered on the language continuum. It is very complex. And you are correct that our instruments to measure written language are limited. Thus, people often rely on subjective processes.
I suggest that assessment include both evaluation of the "mechanics" of handwriting, capitalization/punctuation, and spelling as well as formulation, including vocabulary, syntax and idea organization. Because most of our tests measure narrative writing, it is also important to evaluate expository writing. I recommend use of the WIAT-II.
Georgia Fitzhugh LD evaluations used to require a discrepancy between IQ score and achievement scores. This is not required now.What are the advantages and disadvantages of that change?
It seems that in public school just about every low-achieving student is now labeled learning disabled, whether or not there are other factors which are affecting the child's achievement. This also means that evaluations may not necessarily pinpoint any diagnosis which can really be useful in planning remediation. What do you think?
Blanche Podhajski Ph.D.
Your question is the reason we are experiencing such a sea change in how we identify students with learning disabilities, while, at the same time, improve reading instruction for all children. When 38% of fourth grade children are reading below the basic reading level (National Center for Educational Statistics, 1998), we know that not all of those children have learning disabilities.
RTI is an effort to help general education provide effective instruction in the regular classroom and at increasingly intensive levels of intervention so that youngsters do not fall through the cracks and to increase the accuracy of identifying those with true learning disabilities. Always remember, too, that eligibility determination is not synonymous with diagnosis.
NCLD has an RTI Action Network designed to help address specific questions about how this change translates to practice. Check it out!
Georgia Fitzhugh Are there particular diagnostic tests which are particularly important diagnostically and which you recommend in a standard battery of tests for learning disability?
Blanche Podhajski Ph.D.
Good evaluations should be individualized and based upon the referral question. In general, comprehensive diagnostic assessments for learning disabilities should look at cognitive, linguistic, academic and attentional/behavioral functioning. Within each of these areas, there are excellent tests to pinpoint how the student performs and identify specific strengths and needs. Good evaluations should drive instruction.
Karen Larsen My daughter did not meet eligibility requirements for LD because she hasn't completed all the RTI (interventions).The school states she has to complete the dsylexia intervention before we can look into special ed. I want her re-tested next year so that we can make sure we have not missed anything. Are there certain tests we should ask for?
Blanche Podhajski Ph.D. One of the key elements of RtI is regular progress monitoring. Depending on what reading/spelling skills the dyslexia intervention is targeting - for example, decoding/encoding and fluency - you should be shown how your daughter has responded to that intervention on tests which specifically measure those skills. For more information on progress monitoring, please see the RTI Action Network.
Jenness What would account for a dramatic (1.5 standard deviation) drop in full scale IQ measured three years apart? The child in question is elementary school age and had nothing traumatic happen between testings.
Blanche Podhajski Ph.D.
The first questions I would ask would be whether the measure and evaluator were the same. Often a shift between different Wechsler scales or examiners can be influential. I would also want to know how the factor scores shifted if the Wechsler were used.
Sometimes Verbal IQ can be impacted by severe language or reading disabilities if the child is not able to acquire information or gain vocabulary through listening and reading.
Today's live Talk has concluded. Thank you to Dr. Blanche Podhajski for her thoughtful answers and to the participants for their questions.
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