Neuropsychology In The Era Of RTI

1. Neuropsychology In The Era Of RTI • David Breiger, Ph.D. • Oregon/Washington Bi-state 2010 fall School • Psychologist Conference • October 14, 2010

2. Goals: • 1. Discuss the role of assessment and neuropsychological approaches to assessment: specifically in identifying children with learning disabilities. The relationship between neuropsychological perspectives and the concept of Response to Intervention (RTI) will also be addressed

3. Goals • 2. Review how recent neurobiological knowledge of learning disorders might further educational interventions will be addressed. • 3. Discuss Executive functions as an example of the importance of neuropsychological perspectives and implications for (RTI).

7. The role of assessment and neuropsychological approaches to assessment • Areas to assess (Berninger and Holdnack, 2008 • Cognition and memory • Receptive and Expressive Language • Fine and Gross Motor • Attention and Executive Function • Social and Emotional

8. Neuropsychology has generated measures that have been validated for diagnosing specific ld’s. • For example, in written language, rapid automatic naming (RAN) • RAN has been found to predict response to spelling intervention.

9. Neuropsychological assessments can help identify subtypes of ld’s in reading, arithmetic and writing. • Interventions shown to be effective with identified subtype can then be introduced

10. Willis and Dumont, (2006) provide a useful frame from which to understand the relationship between RTI and what they call cognitive assessment and could be more broadly called neuropsychological assessment.

11. They conclude that the two approaches are complementary and that each is beneficial depending upon the individual child. • RTI approaches can be viewed as preliminary approaches to assess a child’s mastery of specified curriculum which can be more efficient that more comprehensive evaluations.

12. RTI approaches will be best when children are beginning to learn a single, well defined curriculum (e.g., single word reading, addition/subtraction) and have not experienced an extended period of failure.

13. As the task becomes more complicated and multi-faceted, it appears that the RTI approach will be less useful and lead to extended periods of failure if no other evaluation data is collected.

14. How recent neurobiological knowledge of learning disorders might further educational interventions • Evidence from fMRI studies of readers has demonstrated differences in dyslexics relative to typical readers. Successful intervention “normalizes” activiation Evidence from neuroimagining, family genetics and instructional treatment studies have lead to evidence based definitions of ld’s

16. Executive functions: Implications for RTI • Brief review of Executive Functions • Implications for RTI

17. Cheat Sheet for discussion of Executive Functions (EF) • Higher order self-regulatory cognitive processes, including control of attention and motor responses, resistance to interference and delay of gratification

18. EF – umbrella term that incorporates a collection of inner-related processes responsible for purposeful, goal directed behavior. These executive processes are essential for the synthesis of external stimuli, formation of goals and strategies, preparation for action and verification that plans and actions have been implemented appropriately.

19. Processes associated with EF include: • anticipation • goal selection • planning • initiation of activity • self regulation • mental flexibility • deployment of attention • utilization of feedback

20. One Model - Anderson • Attentional Control • selective attention • self-regulation • self-monitoring • inhibition

21. Cognitive Flexibility • divided attention • working memory • conceptual transfer • feedback utilization

22. Goal Setting • initiative • conceptual reasoning • planning • strategic organization

23. Information Processing • efficiency • fluency • speed of processing

24. Another Model – Brown • Activation • Organizing, prioritizing, and activating to work • Initiating, planning, strategizing, and sequencing

25. Focus • Focusing, sustaining, and shifting attention to tasks • Effort • Regulating alertness, sustaining, and processing speed • Pacing, managing time, and resisting distraction

26. Emotion • Managing frustration and regulating emotions • Memory • Utilizing working memory and accessing recall • Using feedback

27. Action • Monitoring and self-regulating action • Inhibiting

28. Five types of situations where routine activation of behavior would not be sufficient for optimal performance – involve EF (Norman and Shallice): • Those that involve planning or decision making.

29. Those that involve error correction or troubleshooting. • Situations where responses are not well-learned or contain novel sequences of actions.

30. Dangerous or technically difficult situations. • Situations which require the overcoming of a strong habitual response or resisting temptation

31. EF in plain English: • Set of mental processes that help us connect past experience with present action. Different cognitive processes that individuals use to control their behavior and get ready to respond to different situations.

32. The term executive function describes a set of cognitive abilities that control and regulate other abilities and behaviors. Executive functions are necessary for goal-directed behavior.

33. They include the ability to initiate and stop actions • to monitor and change behavior as needed, and • to plan future behavior when faced with novel tasks and situations.

34. Executive functions allow us to anticipate outcomes and adapt to changing situations. • The ability to form concepts and think abstractly is often considered components of executive function

35. Executive functions are important for successful adaptation and performance in real-life situations. They allow people to initiate and complete tasks and to persevere in the face of challenges.

36. Because the environment can be unpredictable, executive functions are vital to human ability to recognize the significance of unexpected situations and to make alternative plans quickly when unusual events arise and interfere with normal routines.

37. In this way, executive function contributes to success in work and school and allows people to manage the stresses of daily life. Executive functions also enable people to inhibit inappropriate behaviors.

38. EF processes develop throughout childhood and adolescence and play an important role in a child’s cognitive functioning, behavior, emotional control and social interaction

39. RTI and EF • ??

40. Intervention

41. References • Neuropsychological Perspectives on Learning Disabilities in the Era of RTI:Recommendations for Diagnosis and Intervention. (2008). Edited by Elaine Fletcher-Janzen and Cecil Reynolds • “Executive Skills in Children and Adolescents : A Practical Guide to Assessment and Intervention (Practical Intervention In The Schools)” by Peg Dawson, Richard Guare • Executive Function in Education: From Theory to Practice edited by Lynn Meltzer