Intervention and Prevention of Reading and Writing Disabilities

1. Early Intervention and Prevention of Reading and Writing Disabilities in Preschool and Kindergarten Children Judith Rutberg-Self, Ph.D.

3. It is possible to diagnose and prevent reading (and writing) disabilities  Before children can read!!!

4. Early Intervention is Critical

5. The Case for Early Intervention To the extent that we allow children to fall seriously behind at any point during early elementary school, we are moving to a �remedial� rather than a �preventive� model of intervention. Once children fall behind�it may require very intensive interventions� because of the large amount of reading practice that is lost by children each month and year that they remain poor readers.� Joseph Torgesen, Ph.D., Florida State University

6. Why Early Intervention is Not Widely Used in the Public Schools

7. 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 evidence of intrinsic differences between reading-disabled children with achievement discrepancy and reading disabled children without achievement discrepancy. Both groups make gains with treatment.

8. 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!

10. 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

11. Children Do Not �Outgrow� Learning Difficulties If a child is not learning at the pace of other children, it is generally not a �readiness� issue! �Giving it time�, and �waiting a little longer� results in the child falling further behind and damaging her self-esteem. Early diagnosis and targeted science-driven intervention is critical!

12. Myths about reading and writing Myth # 1 Most children will mature and grow out of their learning difficulties.

13. Reality # 1 No! Research supports a nature/nurture model. It is better to intervene than to wait. There are critical developmental periods in which learning to read is easier. Children do not �mature� out of dyslexia and dysgraphia. Current research does not support retention for academic deficits.

14. Research on Grade Retentionfrom National Association of School Psychologists Initial achievement gains may occur during the year the student is retained, but is not sustained. Retention is associated with significant increases in behavior problems and poor self esteem. Highest rates among poor, minority, or inner-city youth. May have positive impact when students are not simply held back, but receive specific remediation

15. Myth # 2 Dyslexia can be cured by phonics training.

16. Reality # 2: No Some children have deficits in PHONOLOGICAL AWARENESS, and unless that is remediated so they can hear the individual phonemes or speech sounds in spoken words, they will not apply phonics productively.

17. Reality # 2: No Some children have deficits in ORTHOGRAPHIC AWARENESS, and unless that is remediated so they can represent written words efficiently in short-term memory, they will not apply phonics properly.

18. Reality # 2: No Some children have deficits in RAPID AUTOMATIZED NAMING, and unless they can access words from their �mental dictionary� fluently, they will not become automatic decoders and readers.

19. Myth # 3 Some children are auditory learners and some children are visual learners (aptitude-treatment model). Visual learners do best with a �sight word approach�, and auditory learners do best with �phonics�. Children should be taught according to their learning style.

20. Reality # 3 There is no scientific evidence to support the theory of learning styles. It is likely that children who exhibit a particular learning preference may in reality have deficits in the non-preferred area. Both aural (phonological) and visual (orthographic) processes are involved in word recognition.

21. Myth # 4 Dyslexic children see letters and words backward and reversals are a strong sign of dyslexia.

22. Reality # 4 There is no evidence that dyslexic children actually see letters backwards. Reversals are irrelevant to the diagnosis of dyslexia (Shaywitz) Dyslexic children have trouble in naming, but not in copying letters. Backward writing and letter reversals are common in the early stages of writing development.

23. Myth # 5 Left-handedness, difficulties with spatial (including right-left) orientation, trouble tying shoelaces, and clumsiness are associated with dyslexia.

24. Reality # 5 No research findings support the association of clumsiness and coordination problems with dyslexia. The vast majority of dyslexic individuals (about 88 percent) share a common phonologic weakness. (Shaywitz)

25. Myth # 6 Reading disabilities are the most common form of learning disability.

26. Reality # 6 Reading disabilities may be identified sooner, but writing disabilities are more persistent. Writing disabilities are extremely prevalent in the population of children with learning disabilities.

27. What is Dyslexia Dyslexia is a specific language-based disorder of constitutional origin characterized by difficulties in single word decoding, usually reflecting insufficient phonological processing.� Reid Lyon, National Institute of Child Health and Human Development, 1995

28. What is Dyslexia? First signs in kindergarten: Unusual difficulty in learning to name letters and attach phonemes to letters. (Orthographic-Phonological Mapping Relationships) 1st grade signs: Unusual difficulty learning to read single words out of sentence context (sight words and/or phonological decoding).

29. Dyslexia is manifest by variable difficulty with different forms of language, often including, in addition to problems with reading, a conspicuous problem with acquiring proficiency with writing and spelling. Wong

30. Early Warning Signs of Reading Disabilities

31.  Early Warning Signs of Reading Disabilities Delay in Speaking May not begin speaking single words until 15 months and phrases until after their second birthday. May have family history of late talking. Some dyslexic children do not exhibit speech delays.

32. Early Warning Signs of Reading Disabilities Difficulties in Pronunciation Sometimes referred to as �baby talk�. By age 5-6, a child should have little problem saying most words correctly. Typical mispronunciations involve leaving off beginning sounds (�pisquetti�), or inverting sounds (�aminal�).

33. Early Warning Signs of Reading DisabilitiesDifficulties With Rhyming Dyslexic children may show insensitivity to rhyme. Dyslexic children may confuse words that sound alike. It is not a matter of intelligence, but of insensitivity to the sound structure of language.

34. Early Warning Signs of Reading DisabilitiesWord Retrieval Difficulties May use incorrect phoneme � word is close in sound but different in meaning (tornado/volcano). May talk around a word May use filler words like �stuff�, �things� instead of actual name of object. Expressive language problem, not thinking problem.

35. Early Warning Signs of Reading DisabilitiesDifficulty Naming Alphabet Letters This is the most robust early predictor of dyslexia. Many children know the names of most of upper and lower case alphabet letters by the entry of kindergarten. After a full year of kindergarten instruction, children should know most of the letter-sound relationships.

36. Early Warning Signs of Writing Disabilities Difficulties in Gross and Fine Motor Coordination Contribute to Writing Disabilities 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.

37. Early Warning Signs of Writing Disabilities:Difficulty writing the letters of the alphabet from memory: 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.

38. In order to assess and treat reading and writing disabilities, it is necessary to understand the underlying sub-processes.

39. Process Assessment Process assessment has been a method used for treatment of learning disabilities for several decades. However, the �processes� that were addressed in the past were not scientifically proven for the treatment of learning disabilities.

40. Process Assessment Examples of past non-scientifically sound processes to treat learning disabilities and dyslexia Visual-Perceptual training Doman-Delicato (crawling therapy Vision Training/Colored lenses

41. Process Assessment Scientifically valid process assessment treats the underlying processes directly related to reading and writing!

42. Understanding the Functional Reading and Writing SystemVirginia Berninger, Ph.D. Director, U.E. Learning Disabilities Center The functional reading and writing system draws upon different processes which must be orchestrated together. The working brain is like an orchestra; each instrument is a separable component, but the playing of all instruments must be synthesized to play music. (Michael Posner, 1988)

43. Functional Reading and Writing System Phonological system is the aural processing system (hearing) and is the first system to become functional. It is followed by the orthographic processing system (visual system). Handwriting relies on the orthographic-motor component and the ability to recognize, retrieve, and form letters automatically.

44. Functional Reading and Writing SystemPhonemic Awareness Phonological or phonemic awareness refers to the ability to consciously isolate and manipulate the phonemic elements (smallest units of sound) within words. Reading involves converting written letters into their sounds and appreciating that the words are composed of smaller segments or phonemes.

45. Functional Reading and Writing SystemPhonologic Awareness Every language has a basic set of elementary sounds called phonemes. Spoken words are formed by combining these sounds into meaningful sequences. (Sattler, 2002) �Cat� has single letter phonemes that can be segmented into �cuh-ah-t�

46. Functional Reading and Writing SystemPhonological Awareness Phonological awareness also includes the abilities to segment words into syllables, delete and substitute phonemes, recognize rhyme, and appreciate puns.

47. Functional Reading and Writing SystemPhonological Awareness is Developmental Preschool children learn to rhyme (perceive the similarity of sound patterns at ends of words). Mother Goose, Dr. Seuss books Next, kindergarten children perceive and can segment syllables in words (mon-key). Finally, by the end of kindergarten, children can perceive and segment phonemes in monosyllabic words (c-a-t).

48. Functional Reading and Writing SystemOrthographic Awareness Orthographic Awareness involves the ability to process letters and letter units � �built-in spellchecker�. Orthographic ability is a visual, letter-specific process and is separate from being able to recognize and remember other non-letter symbols.

49. Functional Reading and Writing SystemOrthographic Awareness is Developmental Preschool- recognize and produce letter-like symbols. K-1st grade � recognize and produce the letters of their own written language.

50. Functional Reading and Writing SystemOrthographic Coding Orthographic Coding is the ability to represent (image) a written word in memory, including the entire word as well as discrete segments of a word. Before children can pronounce written words, they acquire representations of written words in memory and have some knowledge of acceptable letter sequences found in written English (e.g. �u� follows �q�).

51. Functional Reading and Writing SystemOrthographic Coding is Developmental Preschool children can recognize whole words (their names, �Cheerios�). Kindergarten children can remember if a single letter is in a word. The ability to recall letter cluster groups in words at third grade predicted reading and writing skills (Berninger).

52. Functional Reading and Writing SystemRapid Automatized Naming (RAN) RAN, or rapid naming, is the ability to retrieve the names for objects, colors, digits, or letters efficiently from long-term memory. Measures of rapid naming require speed and processing of visual as well as phonological information. Poor performance on rapid naming tasks is related to difficulty in reading fluency.

53. Functional Reading and Writing SystemRapid Automatized Naming (RAN) The �Double Deficit�: Children with deficits in both RAN and phonological awareness appear to have more difficulties learning to read than individuals with deficits in either rapid naming or phonological awareness alone.

54. Functional Reading and Writing SystemHandwriting Automatization and Accuracy Handwriting is �language by hand�. Writing is unique among the language systems; language by eye (reading), language by mouth (speaking), and language by ear (hearing); because it draws upon the fine-motor system.

55. Functional Reading and Writing SystemHandwriting Automatization and Accuracy Mastery of handwriting is often ignored among preschool and kindergarten students. Formal instruction in handwriting is not always taught. Some students require more explicit instruction in letter formation than other students.

56. Functional Reading and Writing SystemHandwriting Automatization and Accuracy Fine-motor measures such as finger-tapping, finger repetition, finger succession, and finger localization, were shown to be related to writing (Rutberg and Berninger). Students with reading difficulties had difficulty with finger recognition (Fletcher, et. al)

57. Functional Reading and Writing SystemHandwriting Automatization and Accuracy The ability to write the alphabet is a measure of a child�s ability to automatically retrieve from long-term memory and produce with hand an ordered set of written symbols. This task has been found to be the best predictor of writing skills in elementary school children. (Berninger)

58. Functional Reading and Writing SystemHandwriting Automatization and Accuracy EXLICIT INSTRUCTION IN HANDWRITING, AND REMEDIATING HANDWRITING DIFFICULTIES EARLY IS CRITICAL! Unless children are able to automatically retrieve alphabet letters from memory, writing does not become fluent. Children are not able to attend to the higher order thinking processes (spelling and idea generation) unless the lower level process of handwriting is automatized.

59. Preschool and Kindergarten Assessment of the Functional Reading and Writing System

60. Kindergarten Screening BatteryPAL Test Battery for Reading and Writingfor students K-6 Developed by Virginia Berninger, University of Washington. Includes screening measures for children grades K-2. The subtests of the PAL-RW target the neurodevelopmental processes most relevant to learning to read and write.

61. PAL-RW Kindergarten Screening Battery for Reading and Writing ORTHOGRAPHIC /MOTOR SCREENING Alphabet Writing (speed and automaticity of writing alphabet letters in order from memory)(3 minutes) Score is letters formed correctly within first 15 seconds, and time to write entire alphabet Letters must be recognizable out of context

62. PAL-RW Kindergarten Screening Battery for Reading and Writing ORTHOGRAPHIC SCREENING Orthographic Coding (3 minutes) Child views a word for 1 second Child decides if a second word exactly matches the first, or is different Letter Naming (WIAT-II)

63. Example of Orthographic Coding

68. PAL-RW Kindergarten Screening Battery for Reading and Writing RAN RAN � letters (2 minutes) PHONOLOGICAL (5 minutes) Rhyming Syllables

73. The Pre-School Screening Test (PREST 2001, PsychCorp) Ages 3:6-4:5 Developed as preschool screening instrument Training Video Designed to be used by teachers rather than psychologists Divided into two parts. Part one is screener, Part 2 is for children who come out in �at risk� range on part 1

74. PREST Administration time 15 minutes for each part Tests included part 1 (related to reading and writing): Rapid Naming (pictures) Digit Naming Sentence Repetition Copying Letter Shapes

75. PREST Tests in part II Phonological discrimination Digit Span (index of verbal memory) Rhyming Sound Order

76. Other Standardized Assessments for Kindergarten Students Comprehensive Test of Phonological Processing (CTOPP) Woodcock-Johnson-III Sound Awareness (phonological) Letter/Word Identification (naming alphabet Letters)

77. BASIC READING COMPOSITE Assesses pre-reading (phonological awareness) and decoding Skills. Name the letters of the alphabet Identify and generate rhyming words Identify the beginning and ending sounds of words Match sounds with letters and letter blends Read aloud from a graded word list Other Standardized Assessments for Kindergarten StudentsWIAT-II (Co-normed with the PAL)

78. Informal Assessment of Preschool Reading and Writingfrom �Designing Early Literacy Programs- Strategies for At-Risk Preschool and Kindergarten Children�

83. Intervention Activities for Preschool and Kindergarten Students

84. Activities to Facilitate Writing 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.

85. Activities to Facilitate Writing Have children trace letters of their name. Explicitly teach alphabet letters rather than providing incidental instruction. Use a multi-sensory approach. Focus on letter formation. (numbered arrows) Teach lower-case alphabet letters before upper case letters.

86. Activities to Facilitate Writing For children who have difficulties remembering what letters look like, keep a copy of �Talking Letters� on the desk for referral. To help children who have difficulties remembering letters, play the �cover-up� game (covering the letter and having the child write it from memory). Use the PAL Writing Lessons.

90. Activities to promote phonemic and phonological awareness Play rhyming games. Around the home, point to objects and say their names, for example, �sink�. Then ask your child to say as many words as she can that rhyme (wink, pink, blink). Take turns modeling this process. Some easily rhymed words are ball, bread, rug, clock and chair. Let her use some silly or nonsense, words as: ball-tall, call, small, dall, jall, nall

91. Activities to promote phonemic and phonological awareness Say three words such as �cat�, �dog�, and �sat� and ask your child which word sounds different, from the others (dog). This will help your child discriminate between sounds.

92. Activities to promote phonemic and phonological awareness Play the �take away� game. Have your child say a word (�dog�, for example), and then ask her to say it again without the beginning �duh� (d) sound (og). Try a variety of words. Once your child masters this task, try having her delete the ending sound, for example, say �truck:�, now say it without the ending �k� sound (�truh�).

93. Activities to promote phonemic and phonological awareness A much harder task, for older beginning readers, is to have them leave out the middle sound, for example, say �truck��, now take away �r�(tuck). In all of these tasks, make sure you say the letter sound,�rrr� NOT the letter name.

94. Activities to familiarize a child about print Read regularly to your child � quantity and selection are important Read nursery rhymes Reading should be interactive with discussion and open ended questions at appropriate points in story

95. Activities to familiarize a child about print Pair letters with pictures Integrate a picture with the letter (mnemonics) i.e. a lower case h with house drawn under the hump of the h; f forms the stem and leaves of flower Teach upper case, lower case, and sounds separately Teach lower case letters first Use a multisensory approach such as sandpaper letters or finger paints

96. With Early Intervention, Most Reading and Writing Disabilities Can be Prevented.