Assessing and Differentiating Reading Disorders

Linda J. Lombardino, Ph.D.

Professor of Speech-Language Pathology

School of Special Education, School Psychology and Early Childhood Studies

llombard@ufl.edu

Presentation at The Ohio State University

Department of Speech and Hearing Science

January 26, 2012

Model for Assessing Reading and Writing

ASSESSING AND DIFFERENTIATING READING & WRITING DISORDERS: A MULTIDIMENSIONAL MODEL is designed for professionals who evaluate and treat children with reading and writing disorders. It provides a framework for differentiating among various types of reading and writing disorders in order to assist the practitioner in establishing a differential diagnosis. This text introduces a multidimensional model that can be used to create profiles of a learner's strengths and weaknesses using 10 skill domains associated with reading and writing. Samples profiles for preschool and school-age children include assessment protocols, diagnostic reports, and treatment plans. A synopsis of relevant literature related to the relationships between spoken and written language, and the best predictors of reading achievement, along with a chapter devoted to counseling and intervention round out the text to provide a complete roadmap for evaluating the weaknesses and strengths in children who have reading and writing difficulties.

Language Knowledge

Word retrieval

Discourse

Syntax

Morphological Knowledge

Vocabulary

Environmental Factors

Neurological Factors

Grapho-phonemic Integration “Alphabet principle”

Word level reading

Word level spelling

Text level writing

Text level reading

Phonological Knowledge

Print Knowledge

READING ACHIEVEMENT

3 Multidimensional Model for Assessing Reading and Writing (MARwR)

Spoken Language

Vocabulary Understanding of words and word meanings in both spoken and written language

Word retrieval Accessing pronunciations of words or sound patterns stored in memory

Morphological awareness

Understanding that morphemic units exist in words and contribute to the meaning of the word

Syntactic knowledge Understanding how to use grammatical rules and to adhere to word order, morphological

markers, and other syntactic constraints of one’s language

Discourse skills Understanding causal connections and inferences in texts

Print Knowledge

Print awareness Knowledge of book conventions, concept of word in print, and print mechanics

Letter knowledge Knowledge of letter names and ability to write letters that represent letter names

Word awareness Knowledge that words can be segmented into separate units that represent individual spoken

words

Phonological Knowledge

Phonological

awareness

Awareness that the stream of speech can be broken down into smaller units

Grapho-phonemic Integration

Phonics knowledge Mapping phonemes (sounds) onto graphemes (letters)

Invented spelling Knowledge that sounds are represented by letters in some consistent way and use of this

knowledge to create spellings prior to conventional instruction

Skills Targeted in MARwR

[

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Word-Level Reading and Spelling

Decoding Segmenting letters in words into corresponding sounds, then blending sounds to

create real words or nonsense words

Word recognition Recognizing familiar words in print (sight-word recognition) such that sight of

spelling patterns results in immediate word recognition

Spelling Remembering spelling for sound units (e.g., -ight sounds

like /ai/) and knowledge of rules that determine word pronunciations (e.g., silent e

dictates the pronunciation of site)

Text-Level Reading

Reading comprehension Understanding the meaning of information in print

Reading fluency Reading words and text accurately and effortlessly

Text-Level Writing

Mechanics & conventions Handwriting and punctuation

Composition Planning, translating, and reviewing written text

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Summary Sheet for Weaknesses and Strengths

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Preschool – First Grade

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At Risk Classifications for PK – First Grade Children Profile 1: Mixed Language and

Emergent Literacy Deficit

Mild to severely depressed language production and/or

comprehension

Difficulty in one or more phonological processes

Low normal to above average nonverbal intelligence

Absence of primary visual, auditory or motor disabilities

Profile 2: Emergent Literacy

Deficit

Normal language with or without a history of articulation difficulties

Difficulty with emergent literacy skills especially letter knowledge

and sound-letter associations

Low normal to above average nonverbal intelligence

Absence of primary visual, auditory or motor disabilities

Profile 3: Environmental

Disadvantage Deficit

Overall depressed pre-academic skills with or without previous

identification of a language delay or disorder

History of diminished opportunities for exposure to language and to

literacy concepts at home and/or in school

Low normal to above average nonverbal intelligence

Absence of primary visual, auditory or motor disabilities

Classifications

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Profile 1

Mild to moderate

mixed spoken

language & emergent

literacy deficit

Profile 2

Emergent literacy

deficit

Profile 3 *

Environmental

disadvantage deficit

Spoken language

knowledge _ + -/+

Phonological

knowledge -/+ -/+ -/+

Grapheme-

Phoneme

knowledge

-/+ _ -/+

Early Literacy Classifications (4-7 years)

Brittany

Profile 1

Severe spoken language & emergent literacy deficit

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Amanda

Profile 1

Moderate mixed language and literacy

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Carlos

Profile 2

Emergent literacy Deficit

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First Grade & Beyond

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Profile Type Spoken Language characteristics Reading and Writing Characteristics

Profile 4: Mixed

Spoken and Written

Language Disorder

Exhibits depressed oral language

abilities in one or more domains of

language (e.g., semantic, syntax,

pragmatics), however, deficits in

phonological processing

(awareness, memory, rapid) are

often mild and sometimes do not

occur

Typically has a history of early

language impairment

Often shows deficits in production

of oral language narratives and

other forms of oral discourse

Often shows deficits in use of

morphological and syntactic forms

Can exhibit relatively good word

recognition and reading fluency, and

spelling

Exhibits depressed reading comprehension

Exhibits depressed writing composition in

terms of story grammar and other structural

elements of discourse

Morpho-syntactic and semantic errors are

often observed in written composition

Classifications for End of First Grade and Beyond

Gail (9 years) Profile 4

Mixed language and literacy

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Gail (9 years)

Profile 4

Mixed language and literacy deficits

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Profile 5:

Dyslexia

Deficits in phonological and orthographic

coding along with a lack of fluency in reading

Depressed ability to remember the precise oral

pronunciations of words learned, particularly

when they consist of multisyllabic and

complex constructions.

Relatively frequent history of articulation

therapy

Low average or above language production

and comprehension skills depending on the

severity of the word reading deficit

Listening comprehension exceeds reading

comprehension although sometimes holding

lengthy oral directions in memory is difficult

Handwriting varies from good to very poor

Writing conventions, such as punctuation and

capitalization are often ignored or misused.

Depressed phonological decoding of

nonwords, word reading, spelling, and

reading fluency

Listening comprehension exceeds word

reading and reading fluency

Spelling is always impaired and retention

of word spelling is very difficult

Writing mechanics including punctuation

conventions are typically poor.

Morph-syntactic deficits may be apparent

in written language

Handwriting can range from good to

illegible but is typically of poor quality

Evan (10 years)

Profile 5

Dyslexia

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Evan (10 years)

Profile 5

Dyslexia

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Profile 6: Reading

Comprehension

Disorder

Typically unidentified with

learning difficulties until 4th

grade and beyond.

Average to strong phonological

decoding and word recognition

Relatively weak language

comprehension skills at the word

and discourse levels

Weaknesses in telling well

structured and integrated stories

orally and in writing

Variable performance on tasks of

working memory

Word level reading, decoding

and spelling are all superior to

reading comprehension

Depressed reading

comprehension skills,

particularly beyond a 3rd-4th grade

reading level

Harry (14 years) Profile 6

Reading Comprehension Deficit

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Harry (14 years) Profile 6

Reading Comprehension

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Profile 4: Dyslexia Profile 5 : Mixed Spoken

Language and Literacy

Profile 6:

Comprehension Deficit

Listening

comprehension

Language concepts

+ _ -/+

Word-level reading _ -/+

+

Reading fluency

_ -/+ +

Reading

Comprehension

+

_

_

Diagnostic Classifications

Examples of Treatment Recommendations

Dyslexia Orton-Gillingham based approach to reading. Lexercise (http://www.lexercise.com/), an advanced Web-based treatment program for children who have dyslexia or other language-based learning disabilities Touchmath program (http://www.epsbooks.com) Ginger software (http://www.gingersoftware.com)

Mixed Spoken Language and Literacy Language intervention that targets words meanings in the context of listening comprehension activities Reading intervention that targets strengthening her reading fluency and improving knowledge of word meanings Language Tune-Up Kit at Home Reading Software. Quick Reads: A Research-Based Fluency Program Touchmath program (http://www.epsbooks.com)

Comprehension Deficit Strategies for achieving reading comprehension for narrative and expository texts Semantic webbing strategies Comprehension monitoring strategies Making Connections: Explicit Instruction for Comprehension Skills and Strategies

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In-take Forms

• Appendix 3-1. Caregiver/teacher questionnaire for preschool-early first

grade children

• Appendix 3-2. Caregiver/teacher questionnaire for school age children at the end of 1st grade and beyond

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