assessing learning disabilities in adults orbida conference february 22, 2008 ken kosko education...
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Assessing Learning Disabilities in Adults
ORBIDA ConferenceFebruary 22, 2008
Ken KoskoEducation Evaluation Center
The Teaching Research InstituteWestern Oregon University
SLDRehabilitation Services Administration (RSA)1985
Definition:A specific learning disability is a disorder in one or more of the central nervous system processes involved in perceiving, understanding, and/or using concepts through verbal (spoken or written) language or nonverbal means. This disorder manifests itself with a deficit in one or more of the following areas: attention, reasoning, processing, memory, communication, reading, writing, spelling, calculation, coordination, social competence, and emotional maturity. (Rehabilitation Services Administration. (1985, January 21). Program policy directive. Washington, DC: U.S. Office of Special Education and Rehabilitation Services.)
SLDDEFINITION-RSA
Central Nervous System Processes
1. Perceiving
1. Understanding
Spoken or Written Language
Manifestations:
Attention Reasoning Memory Communicating Academics (reading, writing, math) Coordination Social Competence Emotional Maturity
Major Components of a Learning Disabilities Definition
Learning Disabilities:
1. is a general term for a heterogeneous group of disorders
2. are manifested by significant difficulties in listening, speaking, reading, writing, or math;
3. are part of the person make-up (i.e., they will not go away);
4. are presumed to be a dysfunction of the central nervous system;
5. may be discovered across the life span;
6. may RESULT in problems with behavior, social perceptions, and social interactions (but these problems are NOT the disability);
7. are NOT the result of other disabilities such as lost of sight or hearing, lack of intelligence, or lack of schooling.
OREGON DEPARTMENT OF EDUCATIONOregon Administrative Rules 9/19/2007SPECIFIC LEARNING DISABILITIES
A. Achievement Grades 1-121. Basic reading skills2. Reading fluency skills3. Reading comprehension4. Mathematics calculation5. Mathematics problems-solving6. Written expression7. Oral expression8. Listening comprehension
B. Other, if needed:1. Cognition2. Fine motor3. Perceptual motor4. Communication5. Social or Emotional6. Perception or Memory
OREGON DEPARTMENT OF EDUCATIONOregon Administrative Rules 9/19/2007SPECIFIC LEARNING DISABILITIES, Continued
Common Challenges of Successful Adults with LD
Almost all experienced significant difficulty learning in school
Many never did learn to read, write, spell, or compute particularly well
Social skills were either a strength or an area of need
Dealing with LD is a daily task Felt vulnerable because of differences in learning Self-esteem tended to deteriorate when LD went
undiagnosed
(Gerber & Reiff, 1994)
Consequences of LD Beyond School Failure
Poor peer relationships
Poor self-efficacy (ability to produce effects or intended results)
Poor post-school adjustments
Juvenile delinquency
Limited occupational status (under employment)
Mental Health Issues
Anxiety Depression Oppositional Defiant Substance Abuse Alcohol Drugs
Everyday Manifestations
Feeling constantly behind
Fear of filling out forms
Extreme stress or fear associated with any isolated measure of ability
Isolation resulting from fear of being misunderstood
Extreme stress over deadlines
Feeling inadequate because of difficulty doing tasks others find easy
Reading
Slow reader (estimated range up to four times as long to read a page as others)
Reading out of sequence (they went to see a movie=they to see a movie went)
Mistaking one word for another (for=from, to=of) Tracking difficulty: skipping over words or lines Difficulty reading multi-syllable words (aluminum) Difficulty with sound symbols relations Lack of vocabulary understanding & reading
comprehension
Spelling
Reversals common: d=b, friend=friend, (also number reversal: 0137=0317)
Frequently dropping, adding or reversing letters and word parts: know=now, bad, dog=dab dog
Difficulty mixing up words that sound the same; there=their, through=threw, where=wear, well=will, write=right
Forgetting how to spell commonly used words
Writing
Excessive time required to organize papers and thoughts Difficulty conceptualizing a paper’s overall topic and
formulating a thesis on the paper as a whole Tendency to laboriously work out specific parts of the paper
instead of focusing on the paper as a whole Letters reversed Freezing up when trying to write Spelling errors Illegible handwriting; cursive script difficult Words and letters out of sequence in sentences Difficult taking notes in class Completely omitting words or phrases Writing things that make absolutely no coherent sense
Testing
Seldom able to complete exams in class or national exams
Difficulty with multiple choice questions; difficulty filling in the bubbles on forms
Misinterprets directions or questions on exams
Extreme test anxiety
Concentration
Focusing requires extraordinary effort
Easily distracted by noise and movement
Memory
Difficulty recalling familiar things like one’s phone number, address, names of friends
Not remembering what was said or what you were talking about
Not remembering what the teacher/instructor said and trying to take notes
Frequently misplacing, losing or forgetting things
Not remembering what you saw or read, (writing down information from the chalk board or overhead/power point)
Speech
Difficulty pronouncing multisyllabic or uncommon words
Difficulty reading aloud
Stuttering or hesitancy in speech
Difficulty communicating ideas clearly
Orientation
Difficulty in distinguishing left and right
Directions, map reading, and navigating difficulty
Feeling lost in a familiar setting; easily disoriented
Ranges of LDJournal of Learning Disabilities, 29, 17-30
MILD average to above average intelligence
adequate psychological adjustments and vocational/employability skills
high academic achievement
limited processing and language skills
Ranges of LD, cont.Journal of Learning Disabilities, 29, 17-30
MODERATE average to above average intelligence
some cognitive and language deficits
one or more academic disabilities
some psychological adjustment problems
difficulty with vocational/employment skills
Ranges of LD, cont.Journal of Learning Disabilities, 29, 17-30
SEVERE display below average intelligence
significant cognitive processing and language deficits
low academic achievement
lack of psychological adjustment
lack of vocational/employment skills
Why Assess?
Determine eligibility
Determine strengths, abilities, and deficits
Determine appropriate instructional setting
Determine job match
Determine level of self-determination skills
Determine necessary accommodations, supports, and services
Primary Area Assessed Through Functional Assessment in Disciplines Related to Special Education
Function Area Constructs Measured
Behavioral/Psychosocial
Family Relations; personality;interpersonal relationships; behavioral surpluses and deficits
Communication Auditory and visual reception; oral and graphic expression
Cognitive Intelligence; attention, impulsivity;memory; problem solving; auditory,visual, and spatial perception
Physical Gross mobility; fine motor skills; strength and endurance
Primary Area Assessed Through Functional Assessment in Disciplines Related to Special Education
Function Area Constructs Measured
Daily Living Self-care; home maintenance; community awareness and use
Vocational Aptitudes; interest; academic skills; job seeking skills; job maintenance skills
Environmental Environmental demands; available support structures and practices
The functional areas and constructs measured presented are not exhaustive.
(Nelson, Roberts, Bullis, Albers & Ohland, 1999)
DIAGNOSTIC CRITERIA FOR ADULT LEARNINGDISABILITY DETERMINATION
There are several commonly accepted criteria that evaluators rely on when considering determination of whether or not an individual has a Learning Disability. Following are what appears to be the most commonly used criteria, keeping in mind that meeting only one of the following two criteria should not be used as the sole determinant of LD.
1. A significant discrepancy between overall cognitive ability and achievement in reading, math and/or writing as indicated by:
a) DSM-IV Edition-TR-Usually defined as a discrepancy of more than two standard deviations between achievement and IQ. A smaller discrepancy is sometimes used, (between one and two deviations), “especially in cases where an individual’s performance on an IQ test has been compromised by an associated disorder in cognitive processing, a co morbid mental disorder or general medical condition, or the individual’s ethnic or cultural background”;
b) A discrepancy of one and a half to two standard deviations;
c) Use of the regression formula;
d) A combination of discrepancies and professional judgment;
AND
2. The ability to process information is impaired in some way that is directly contributing to underachievement and is impacting the individual’s ability to learn or retain information in school, work and/or daily living activities.
DIAGNOSTIC CRITERIA FOR ADULT LEARNINGDISABILITY DETERMINATION, cont
Other Considerations The underachievement cannot be primarily due to factors other than a
processing deficit (e.g., lack of schooling, mental health issues, drugs and alcohol, hearing impairment, visual acuity problems);
With adults, a history of learning problems during their school careers is usually noted i.e., elementary, middle, high school. May have dropped out of school;
A history of learning problems in the family (e.g., parent/s, siblings, children);
Uneven development in cognitive and/or achievement areas. Full Scale Cognitive scores are normally within the average range or better, however, adults IQ’s who have had a history of school difficulties (may be drop outs) can be somewhat lower and in the low average range.
Determination of eligibility should not be made based only on one subtest.
Screening for possible social/emotional issues (e.g., depression, anxiety) and ADHD, which may be part of the LD assessment.
DIAGNOSTIC CRITERIA FOR ADULT LEARNINGDISABILITY DETERMINATION, cont.
Test Scores:
Care must be taken when analyzing cognitive, achievement and processing tests. A full scale IQ score in the Borderline range (70-79) does not necessarily mean an individual has Borderline intellectual functioning. When examining the subtest, full scale and Index scores there may be areas well within the average to above average range with significantly low subtest scores related to LD that make the client look Borderline functioning. A client with a Borderline Performance score and low to average Verbal score may appear to be borderline functioning if one relies only on the Full scale scores without taking into consideration variation in scores. A number of studies on low to borderline IQ are proving that individuals with low to borderline IQ may also have learning disabilities. Good diagnosticians don’t rely solely on the numbers. ( www.seakingwdc.org/ld/Formal Test.htm)
(Adapted from Washington State Learning Disabilities Project, Summary Report, 1998)
Characteristics of Diagnostic Testing
Is individually administered and scored; Can take from several hours to several days for testing
and several more days for interpretation of results; Can cost anywhere from $600 to $1,500, depending on
the extent of testing required for a diagnosis; Must be administered only by a qualified professional
who is licensed to administer psycho-educational test batteries;
Provides in-depth assessment of an individual’s skill areas; and
As a result of diagnostic testing, individual knows for certain whether he/she has a learning disability, including information on how the specific LD affects performance.
Information Processing and Related Disabilities
Input Process Output
Auditory
Visual
Tactile
Olfactory
Gustatory
Thinking*Abstract *Concrete Memory*Auditory *Visual*Long Term*Short Term Sequencing Organization Attention
Talking
Reading
Writing
Motor
*Fine *Gross
Fluency/Speed
Accuracy
Four Stages of Information Processing and Related Disabilities
1. Input Visual Perception Disability Auditory Perception Disability
2. Integration Sequencing Disability Abstraction Disability Organization Disability
3. Memory Short-term Long-term
4. Output Language Disabilities: Spontaneous and Demand Motor Disabilities: Gross and Fine Muscle
Coordination
Types of Assessment Instruments
Norm Referenced Wechsler Adult Intelligence Test-III
Woodcock-Johnson Psycho-Educational Battery
(Cognitive & Tests of Achievement)
Wechsler Individual Achievement Test
Nelson Denny Reading Test
Scholastic Abilities Test for Adults
Detroit Test of Learning Aptitude
Types of Assessment Instruments
Rating Scales Conners’ Adult ADHD Rating Scales-
Observer-Report Conners’ Adult ADHD Rating Scales-Self
Report Brown Attention-Deficit Disorder Behavior Assessment System for Children,
Second Edition, Self-Report College (18-25), Self-Report Adolescent (12-21)
Types of Assessment Instruments
Self-Report
Interview
Observation
Learning Disability Evaluation Report
(see handout)
Definition of Self-Determination
The attitudes and abilities requiredto act as the primary causalagent in one’s life and make
choices and decisions regardingone’s action free from undue external
influence or interference
[Source: Wehmeyer, M.L. (1997). Self-directed Learning and Self Determination. In M. Agran (Ed.), Student-directed Learning: A Handbook of Self-Management. Pacific Grove, CA: Brooks/Cole.]
Accommodations
An accommodation:
is any change needed to help the employee learn the skill required to perform the job.
It may mean:
Using different kinds of learning materials;
Using special equipment, such as a computer or a calculator;
Having a special tutor or work “buddy” to help on the job;
Using auditory aids and services.
An accommodation:
does not include making changes in rules to make it easier for the person with LD to perform the work than for other employees; and
should not create an “undue hardship” for the employer. It is not necessary to provide the most expensive accommodation, just one that will help the employee do what needs to be done.
Work Skills*What skills employers want -versus - What does the job require
The three R’s (reading, writing, and arithmetic).
Organizational effectiveness/leadership (the ability to get things done and to lead).
Self-esteem/goal setting-motivation/personal and career development (feeling good about what you are doing and where you are going).
Interpersonal skills/negotiation/teamwork (the ability to successfully work with co-workers).
Problem solving/creative thinking (the ability to overcome obstacles encountered by the worksite).
Listening and oral communication (the ability to interact effectively with co-workers).
Learning to learn (the willingness to learn new tasks/skills on the job).
*Carnevale, Gainer, and Meltzer (1988)
TOOLS
* Environmental School Assessment Measure - E-SAM
* Environmental Job Assessment Measure - E-JAM
*from: PRO-ED, Functional Assessment In Transition and Rehabilitation For Adolescents And Adults With Learning Disorders, 1999.
Environmental Settings and Demands for Clients
Demands of the job
Demands of the school
Demands of the training site
Demands of the classroom
Demands of DHS
Secretary Commission on Achieving Necessary Skill (SCANS report)
Physical demands
Working conditions
Educational demands
General work behavior
Social interaction
Common Strengths of Successful Adults with LD
Able to cope and compensate for LD
Determined to achieve
Willing to work hard
Found ways to learn that led to success
Recognized and accepted LD-“goodness of fit” in jobs/tasks assigned to them
Used technology
Recognized need for support and found/had it
(Gerber & Reiff, 1994)
What is Success?Quotes from Successful Adults with LD
Achieving a goal
Establishing a realistic goal and then achieving it
Overcoming overwhelming odds
Setting goals and attaining them
Being happy in whatever you do
Feeling that you have accomplished what you set out to do
(Gerber & Reiff, 1994
Assessment Instruments for Transition, Career Planning, Jobs
CAREER CLUSTERS
Crafts Scientific The Arts
ManualSkilled CraftsTechnicalMath-ScienceMedical-Dental
Math-ScienceMedical-Dental
LiteraryArtsMusicEntertainment
The Harrington-O’Shea Career Decision-Making System American Guidance Service
Assessment Instruments for Transition, Career Planning, Jobs
CAREER CLUSTERS
Social Business Office Operations
Customer ServicePersonal ServiceSocial ServiceEducation
ManagementLegal
ClericalData Analysis
The Harrington-O’Shea Career Decision-Making System American Guidance Service
Assessment Instruments for Transition, Career Planning, Jobs
Work Values
Outdoor Work Good Salary Prestige
Physical Activity Independence Variety
Risk Job Security Leadership
Work with Hands High Achievement Creativity
The Harrington-O’Shea Career Decision-Making System American Guidance Service
Assessment Instruments for Transition, Career Planning, Jobs
The COPSystemEdit/Educational & Industrial Service, San Diego, CA 92176
CAREER CLUSTERS1. Science Professional 2. Science Skilled
3. Technology Professional 4. Technology Skilled
5. Consumer Economics 6. Outdoor
7. Business Professional 8. Business Skilled
9. Clerical 10. Clerical
11. Arts Professional 12. Arts Skilled
13. Service Professional 14. Service Skilled
Assessment Instruments for Transition, Career Planning, Jobs
Enderle-Severson Transition Rating Scale (ESTR-J)(Transition assessment for adolescents with mild disabilities)Practical Press, PO Box 455Moorhead, MN 5661-0455
ESTR-J PROFILEJobs and Job Training
Recreation and Leisure
Home Living
Community Participation
Postsecondary Training & Learning Opportunities
Total Performance Score
Assessment Instruments for Transition, Career Planning, Jobs
The Arc’s Self-Determination ScaleThe Arc of the United States500 E. Border St. Suite 300Arlington TX 76010
SCALE PROFILEAutonomy
Self-Regulation
Psychological Empowerment
Self-Realization