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Understanding Specific Learning Difficulties: Identification and Diagnosis
(Briefing)
Helen Duncan (Disability Adviser (SpLD))
Disability Resource Centre
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Aims
This session aims to promote an understanding of:
•The SpLD assessment process and model
•How an SpLD diagnosis is obtained
•The time frame for the SpLD diagnostic process
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Aims: to address common concerns
Commonly asked questions:
•Why are students assessed for the first time at University?
•How robust is the assessment process?
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Assessment process
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What is Dyslexia?
• Definition (handout)
• Problems in:
• Speed of processing (visual and phonological)
• Working memory
• Phonological awareness
• Deficit model / discrepancy model
• Subtle profiles – relative /absolute difficulties
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Profile of dyslexia ‘spiky profile’
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Case study – Jane e-mails DRC
Student receives e-mail from SpLD administrator with following:
• Appointment date (up to 2 weeks) & Confidentiality agreement (disclosure)
• Pre-screening questionnaire (self-completion)
• Closed questions and narrative responses
• Students own description of difficulties/concerns
• Referral for eye test
• Eliminate eye conditions as reasons for literacy problems
• Request for sample of unedited handwritten notes (lecture notes / supervision essay)
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Jane – pre-screening questionnaire
What do her responses indicate at this stage?
• Working memory (times tables / sequencing ideas)
• Phonological awareness (poor at listening aspect of French, difficulty with new words)
• Speed of processing (slow reading, slow writing of ideas)
Refer to definition of dyslexia
Familial history of SpLD (brother, father)
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Screening interview - purpose
• 1:1 with SpLD specialist
• Structured interview
• Questions are trigger points
• Looking for patterns consistent with SpLD (or other)
• Eliminate other reasons for the difficulties
• Norm referenced tests
• To support/contradict interview findings
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1.5 hour screening interview – structured questions
Medical Background
•Eliminating other causes for difficulties :• depression, epilepsy, ME, Anorexia, medications, etc.
can affect working memory & speed of processing. • Eye conditions and hearing loss can affect literacy skills
•Noting any medical conditions that are positive indicators of SpLD (allergies, recurrent ear infections as child, premature birth)
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Screening interview – educational background
• Identify that signs of SpLD were present throughout schooling (albeit not diagnosed)
• Difficulties in specific areas relating to dyslexia (i.e. not general problems)
• Learning additional languages• Essay writing (structure/organisation)• Lack of automaticity of literacy skills• Discrepancies across subjects
• Eliminate other causes for difficulties (changes of school/ unconventional schooling, additional languages)
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Screening interview – structured questions
• Language/listening behaviour
• Writing and spelling
• Reading
• Note-taking
• Maths
• Memory
• Spatial/temporal
• Visual motor
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Screening interview – data
• Adequate cluster of signs of deficits in:
• working memory
• Processing speed
• Phonological awareness
• Select norm referenced tests to test findings:
• Speed of reading (TOWRE form A – SS=89)
• Spelling- (WRAT –IV blue - SS= 105)
• Rapid naming (objects and colours) (CTOPP – SS= 85)
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Screening interview – Jane’s outcome
• Test results lower than expected
• Test results consistent with reported problems in processing speed and spelling
• Outcome warrants referral for full diagnostic assessment to EP
• Write up outcome of screening interview as short report and pass this to diagnostic assessor (see handout).
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Full Diagnostic assessment
• Appointment with EP – around 2 weeks from referral by DRC (longer if student needs to obtain funding from ALF)
• DRC pool of EP’s are quality assured by DRC & liaise closely with DRC Disability Advisers
• Student may need to travel to London
• Session lasts around 4 hours & Costs £400
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Full Diagnostic assessment - Jane
•Verbal comprehension (verbal IQ -WAIS-IV – 4 subtests) –SS=151
•Perceptual organisation (nonverbal IQ – WAIS-IV – 4 subtests)- SS=150
•Processing speed ( visual processing -WAIS-IV – 2 subtests) SS=89
•Working memory( auditory memory - WAIS-IV – 2 subtests) SS= 96
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Full Diagnostic assessment - Jane
• Phonological processing
• Phonological awareness (2 x CTOPP subtests) SS=90
• Phonological memory (2 x CTOPP subtests) SS=95
• Speed of processing phonological information from long term memory (rapid naming) (2 x CTOPP subtests) SS=90
• Supplementary CTOPP subtests available if needed
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Full Diagnostic assessment - Jane
• Single word reading (untimed) (WIAT-II – SS 110)
• Single word reading (timed) (TOWRE – SS 90)
• Non-word reading (timed) (TOWRE– SS 88)
• Reading comprehension ((ART)
• Reading Accuracy – SS= 92
• Comprehension –SS=110
• Speed of Reading (rate) – SS=84
• Writing Speed (wpm) - 19 wpm (average undergraduate = 24 – 28wpm) (5 min precise task)
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Full Diagnostic assessment - Writing/Spelling
• Single word spelling – SS= 101
• Timed prose writing (20 minutes)
• Spelling when writing in prose
• Use of expressive vocabulary
• Organisation of ideas
• Sentence structure/ grammar & punctuation
• Legibility and speed of handwriting (17 wpm)
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Full Diagnostic assessment - outcome
EP Compares:
1. data across all the psychometric tests & test behaviour
2. outcome of screening interview
3. students self report of difficulties
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Full Diagnostic assessment - outcome
Diagnosis of dyslexia due to all consistently showing similar degree of deficit in:
• Working memory
• Speed of processing
• Phonological awareness
•Therefore, meets definition of dyslexia (see definition on handout)
•Recommendation is 25% extra time in exams to compensate for slow processing speed (slow reading and writing) and poor working memory (need to re-read)
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Diagnostic assessment process - timeframe
• Student contact – screening interview appointment = 2 weeks
• Screening interview appointment – EP appointment = 2 weeks
• EP write up report = 2 weeks
• Student feedback appointment at DRC for support arrangements = 2 weeks
• Minimum of 8 weeks from initial contact to discussion of report and support arrangement
• In addition – during feedback meeting student applies for DSA to fund support– 12 weeks process before funding for support is available.
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Diagnostic assessment process
Any questions?
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Diagnostic assessment process
Useful contacts and links:
•DRC website
•Inclusive teaching DRC Online resources (via DRC website)
•DRC workshops : Teaching students with Specific Learning Difficulties (via PPD)