Prevention and Intervention for

Writing Disabilities

Prevention and Intervention for

Writing DisabilitiesPresented by

Nancy Mumm, MS. CCCJudith Rutberg-Self, Ph.D.

Two Compositions by Arthur The mn was sneB (2nd grade)

(In response to a picture of a girl showing her father a large fish she had caught)

I think theu shold no how to speek dififering langwges. If theu go to like dutch countri sombodie might ask them something theu cold have two kinds of langage. (5th grade)(In response to the teacher’s query, “Should children learn a second language?)

April’s Story

When April starts to write, she feels overwhelmed. So she writes as little as she can get away with ( and sometimes less than she can get away with). She is often accused of being lazy and irresponsible. She isn’t lazy at all. She explains “Whenever I try to write, I lose my ideas and get all mixed up about them. Then, when I see what I am writing, it is all a big mess and the ideas that come out are not the ones in my head. They look babyish and stupid. Then I’m afraid that one of my friends will see what I wrote or my teacher will show it to everyone or my parents will get real mad and say that I wasn’t even trying. I hate to write”.

Writing is a highly complex and demanding process Organization

Form and features

Rules and mechanics

Purposes and goals

Audience needs and perspectives

The Writer Must Be

Goal oriented

Resourceful

Reflective

Writing – There’s more to it than meets the eye!

Writing is not the mirror image of reading. Competent readers do not necessarily become competent writers.

In addition to recognizing letters automatically, one must learn to produce letters automatically.

Learning spelling patterns is more complex than learning to read them.

Writing – There’s more to it than meets the eye!

Putting ideas in writing is a more complex task than putting ideas into words. Children with difficulties in speech and language are at higher risk for writing disabilities.

Learning to spell is more complicated than learning to read. There are many more speech- to- sound variations than letter-to-sound variations.

Writing – There’s more to it than meets the eye!

Writing is Language by Hand

Reading is Language by Eye

Learning to Talk is Different Than Learning to Write

Speaking is a social interaction between cooperative, supportive partners.

Writing is solitary and the responsibility of the communication is solely on the writer.

Incidence of Written Language Disabilities

Extremely prevalent in the population of children with learning disabilities

Reading disabilities may be identified sooner, but writing disabilities are more persistent

While there has been tremendous research in reading, writing research has been limited or ignored

Children with oral language impairments are six times more likely to have difficulty reading (and hence writing) than typically developing peers (Catts)

Common Behaviors of Writing Disabled Students

Minimal planning- they draw information from memory that is somewhat appropriate, writing it down and using each idea to stimulate the generation of the next one (Graham)

Minimal attempts at revision, revision tends focus on correcting mechanical errors

Struggle with mechanics of writing – spelling, capitalization, punctuation, handwriting fluency

Overemphasize mechanics over form and process of writing

Current Writing ResearchUniversity of Washington - the “Write Stuff”

for Preventing Writing Disabilities Ongoing Since 1989

Principal Investigator – Virginia Berninger, Ph.D, Developmental Psychologist

Funded by National Institute of Child Health and

Human Development

Focuses on writing development, causes of writing disabilities, and science-based treatment to remediate writing problems in children

Myths and Realities about Writing Disabilities

Abstract of a Decade of Research at the UW

Myth 1:Reading Disability is the most common form of Learning Disability

Reality: Writing Disability is more prevalent Children who initially struggle with reading

usually learn to read but have residual writing problems

Many children who can read well have writing problems

Many students who perform poorly on State designed assessments of writing have undiagnosed writing problems

Myths and Realities about Writing Disabilities

Abstract of a Decade of Research at the UW

Myth 2: Writing Disability is a Motor Problem Reality: Writing Disabilities, like reading

disabilities, are heterogeneous

Students may have difficulty with only one or a combination of specific problems

The most common contributing process in elementary school is handwriting and/or spelling

Writing is fundamentally a language and conceptual activity

Myths and Realities about Writing Disabilities

Abstract of a Decade of Research at the UW

Myth 3: Only higher level “conceptual processes” should be taught.

Reality: Lower and higher levels of language need to be taught. The ability to write alphabet letters automatically is a very strong predictor of the quality of writing. Handwriting should be taught explicitly, not incidentally.

Myths and Realities about Writing Disabilities

Abstract of a Decade of Research at the UW

Myth 4: Writing instruction should be aimed only at meaning and ideas.

Reality: All areas of written language should be addressed within the same instructional session. Handwriting, spelling, and composition should be taught together, and instruction should be explicit.

Two Types of Writing Disabilities Have Been Discovered

University of Washington “The Write Stuff”

One group has initial trouble learning to read, responds well to instruction, but has persistent writing disabilities

Another group has writing disabilities without reading difficulties

Several Reasons for Writing Difficulties University of Washington “Write Stuff”

Underdeveloped spelling, handwriting, or composing skills, singly or in combination

Processing problems including automatic letter retrieval and production, working memory, fine-motor planning, orthographic (visual) or phonological (auditory) coding of letters and words

Attention Deficit Disorder/Executive Function Deficits

Lack of a school program with coordinated, explicit instruction in writing

Genetic studies have found written spelling difficulties to be inherited

Handwriting

Luria (Russian psychologist) described writing as a “Kinetic Melody” – and compared the act of writing to a finely tuned orchestra (many actions occurring at the same time)

Kinetic Memory

Requires balancing, flexing, and contracting movements as well as simultaneously stimulating some muscle groups while inhibiting other muscle groups, just as an orchestra requires the balancing of many different instruments, sound levels, and rhythms.

Multiple Brain MechanismsHandwriting

Gross and Fine Motor Coordination 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.

Multiple Brain MechanismsMotor Memory

Students with motor memory problems may take a long time to learn to form letters.

Difficulty getting the motor movements

(engrams) for letter formation to be automatic.

Cursive writing may be difficult because of the hundreds of little movements needed to make and connect the letters

University of Washington“Write Stuff”Handwriting

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.

University of Washington“Write Stuff”Handwriting

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.

The ability to process the sound structure of spoken

words (phonological awareness) is directly related to spelling.

Learning to spell requires linking the spoken word to the written word, not simply visual memorization (look, cover, write).

Children need to understand that the sound structure of words is related to the structure of written words, although not always in a perfect way.

University of Washington“Write Stuff”Spelling

Children do not learn to spell or read “letter by letter

Children need to understand that letters and letter units are used to translate units in the spoken word to units in the written word.

Functional spelling units are usually one or two letters in size (ph, oa, ng)

Children who learned associations for two letter spelling units made the most progress in learning to spell and recognize words.

University of Washington“Write Stuff” Spelling

University of Washington“Write Stuff” Spelling

Children need repeated practice writing specific words to dictation

Exclusive reliance on incidental instruction during the “teachable moment” or use of personal dictionaries is not sufficient to teach spelling.

A minimum of 24 practice trials, distributed over a 2 month period, was needed for at-risk 2nd graders to master spelling words.

Spelling requires more than sound/symbol

correspondence!

In composition, journal writing is ineffective with students who have writing disabilities.

Children need guided assistance in the form of prompts

Graphic organizers are useful to help struggling writers plan what to write

Teacher modeling in which the teacher thinks aloud while planning, is helpful for teaching struggling writers.

University of Washington“Write Stuff” Composition

Multiple Brain MechanismsInvolved in the Writing Process

Writing requires the simultaneous and sequential integration of many sub-

processes

Writing

Executive FunctionsAttention

Organization/Planning and RevisingWorking Memory

Language and Higher Order

Cognition

Vocabulary Semantics

Memory

Spelling Patterns Motor Memory

Integration of Multiple

Information Sources

Gross and Fine Motor Skill

Handwriting

Executive Functions

Barkley: Those actions we perform to ourselves and direct at ourselves so as to accomplish self-control, goal directed behavior, and maximize future outcomes

Brown: The conductor’s role in an orchestra McCloskey: A large collection of “semi-

conductors”, each responsible for a separate aspect of the overall production of the orchestra, but each working in a collaborative manner with the others

Frontal Lobe = Command CenterExecutive Function Control

Internalizing Language (Self-Talk)

Controlling Emotions

Organization Planning and

Revising

Working Memory

Activation, Arousal, Effort, Paying Attention

What is Included in Executive Functions?

Holding facts in mind while manipulating information; accessing facts stored in long-term memory

Activation, Arousal, and Effort (getting started; paying attention; finishing work)

Ability to tolerate frustration; thinking before speaking or acting

Using “self-talk” to control one’s behavior and direct future actions

Taking an issue apart, analyzing the pieces

Executive Functions of WritingAttention

Attention• Involved in planning and producing responses

(April’s difficulty)• Handwriting is often a problem in children with

attention problems (location in brain)• Some children with AD/HD who have handwriting

problems show dramatic improvement in handwriting when given stimulant medication (Berninger)

• Writing development should be closely monitored in any child with AD/HD

Executive Functions of WritingAttention

Research by Mayes and Calhoun identified written expression as the most common problem of students with AD/HD (65%).

Consequently, writing essays, drafting book reports, or answering questions on tests or homework is often very challenging for these students.

A Careful Diagnosis is Critical

Executive Functions of WritingWorking Memory

The ability to hold information in mind while processing and manipulating it

Spelling Rules and

Patterns

Mechanics

Memory for Facts and

Ideas

Vocabulary and Word Finding

Motor Programs Forming Letters

Executive Functions of WritingWorking Memory

Written language difficulties include: Difficulties holding ideas in mind Quickly retrieving grammar, spelling, and

punctuation rules from long-term memory

Manipulating all this information Remembering ideas to write down Organizing material in a logical sequence Reviewing and correcting errors

Problems that Impact Working Memory

Attention and Concentration Slow Processing Speed Automaticity of lower-level skills

Automaticity of producing alphabet letters

Automaticity of spelling (knowing patterns)

Poor fine-motor/handwriting ability

Output Controls Necessary for WritingDr. Mel Levine

University of North Carolina Medical SchoolDirector of Clinical Center for the Study of Development and Learning

Output Controls

Monitoring and Regulating

Quality Control

Evaluating and Using Feedback

Reinforcement Control

Learning from Previous Experience

Option Controls

Making Decisions and Choosing Best

Alternative

Pace Control

Processing Speed

Too Slow vs. Rushing

Previewing/Planning Control

What are the

Requirements?

(blueprint)

Diagnostic Assessment of Writing

Current Achievement Measures

Educational/Instructional Program

Executive Function/Attention

Lower Level Processing Skills

Assessment of WritingLower Level Processing Skills

Orthographic Awareness

The ability to hold words, letter groups, and letters in memory -the ability to “image” words in the mind

Writing words and nonwords viewed briefly (1 second)

Reading words and nonwords viewed briefly (1 second)

glitter

a

physical

a

fracagen

3rd and 4th letters

Lower Level SkillsPhonological Awareness

Hearing the sounds that make up words

Understanding that “CAT” is made up of the individual speech sounds “C-A-T”

Say “string” Now say it without the “st”

Say “sprite” Now say it without the “p”

Lower Level SkillsPhonological Memory

Repetition of nonsense words The ability to hold in mind the sounds

within words

Important spelling multi-syllabic words

Poor phonological memory - forget the beginning of word by the time the end has been decoded

Lower Level SkillsLanguage Processing Measures

Formulated Sentences (semantics) Viewing a picture and making up a sentence

about it using particular required words Measures language skills

Word Fluency Write all the words that you can think of that are

round Measures access to words from “mental

dictionary”

Rapid Automatized Naming (RAN)

The ability to quickly read letters, words, numbers.

A measure of the access to “name codes” – fluency of language

Related to reading fluency, processing speed

S X C G H K S B E W F S

L U T B C E A Q K L R V

H T B P T D X Z G B E F

K J R G C M U X G E S L

P U V D S Q A Z J F A T

R L K V E G M O Q P D A

Lower Level SkillsHandwriting Measures

Related Fine Motor Processes Finger repetition Finger succession Finger localization

Automatic retrieval and production of ordered alphabet letters

Copying Written text (speed and fluency)

Achievement Measures Composing

Sentences and Paragraphs – quality

Writing Speed and Fluency Measures Writing simple sentences quickly

Spelling Real Words Pseudowords (made-up words that follow regular spelling

patterns) brangle, snirk, psychomation

Vocabulary Development

Mechanics

Cognitive Processing

Cognitive Processes

Verbal Comprehension Working Memory Processing Speed Perceptual Reasoning

Vocabulary KnowledgeComprehension

Holding Events in Mind“Mental Scratchpad”

Speed of Information Processing

Output Speed

Visual Spatial AbilityNonverbal Reasoning

Attention/Executive Function Cognitive Assessment (IQ)

Processing Speed Working Memory

Behavioral Checklists Parent Teacher Self-Report

Neuropsychological Assessment Planning/Organizing/Impulsivity/Attention

Observation Classroom Testing

Educational/Instructional Assessment

Classroom Observation

Records Review

Curriculum Review

Teacher Interview

School Assessment for Special Education Services

School assessment focuses on qualification for services using the “severe discrepancy model”.

School assessment is not designed to be diagnostic.

A child can have a significant learning disability and not qualify for special education services.

What is a Specific Learning Disability?Definition From the Individuals With

Disabilities Act (IDEA)

Specific Learning Disability: A disorder in one or more of the basic psychological

processes involved in understanding or in using language spoken or written, which may manifest itself in an imperfect ability to listen, speak, read, write, spell, or do mathematical calculations

Does not include problems resulting from visual, hearing, or motor handicaps, mental retardation, emotional disturbance, or environmental, cultural, or economic disadvantage. (1967, 1975 Federal Guidelines)

How Do Children Qualify for Services?

Current guidelines use a" discrepancy formula” to determine the presence of a “Specific Learning Disability” (SLD)

Severe discrepancy between ability (as measured by IQ) and achievement (as measured by current academic achievement testing)

If there is not a significant difference between predicted scores based on IQ, then it is assumed that the child is performing at the “expected level” and does not meet criteria for services.

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 scientific evidence of intrinsic differences between children with achievement discrepancy and children without achievement discrepancy. Both groups make gains with treatment.

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!

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

Intervention

Best Practices in Treating Writing Problems

Be Wary Of….. Unsolicited assessments or screenings by people

offering “free screenings” for learning problems, and then recommending their type of intervention.

Alternative and unproven therapies that propose to “cure” learning disabilities. There is no “cure” for learning disabilities, per se.

Assessment that is not directly related to the specific academic deficit. Scientific research does not demonstrate the efficacy of “crossed dominance theory”, “learning style”, “eye tracking exercises and colored lenses”, or “sensory integration” as interventions for reading, writing, spelling, or math disabilities.

InterventionWhat Works

Handwriting Automaticity Training PAL Guides Big Strokes for Little Folks

PAL Writing Lessons

PAL Talking Letters Desk Guide

Spelling Marsha Henry’s Words Program

Word Structure Analysis Greek and Latin Roots/Morphology

How To Teach Spelling

PAL Talking Letters

PAL Orthographic Awareness Training

Executive Function Approach to Writing:Self-Regulated Strategy Development (SRSD) Graham and Harris

Developed 15 years ago

Belief that every child can write

Teaches specific strategies for Planning Writing Revising Editing

Self-Regulated Strategy Development (SRSD) Goal Setting

What is required? Self-instructions

“self-talk” - modeled by teacher Self-monitoring

checking for accuracy Self-assessment

Did I meet my goals? Self-reinforcement

Making the work meaningful

Example of an SRSD Strategyfrom Graham and Harris “Making the Writing Process Work”

Three-Step Planning 1. Think-who will read this?

Why am I writing this?

2. Plan what to say – Use S-P-A-C-E Setting Purpose Action Conclusion Emotions

3. Write and Say More

Other Cognitive Strategies for Writing

Mnemonic Strategies for Theme Writing TOWER

Think of Ideas Order Ideas Write Ideas – connected paragraphs Error Monitor (organization, sentence

structure, minor errors) Recopy (for neatness, format)

Other Cognitive Strategies for Writing

Mnemonic Strategy for Error Correction – COPS

Capitalization Overall Appearance Punctuation Spelling

Assistive Technologies

Voice Recognition Computer Software Dragon Naturally Speaking

Mind-Mapping Computer Software Inspiration, KidSpiration

Keyboarding Alphasmart

504 or IEP Recommendations and Accommodations

Classroom Tape recording class lectures Algorithms for checking work on desktop Not having writing corrected by classmate Extra time on written tests including SAT, WASL Oral tests instead of written tests Pre-written class lecture notes Alpha-Smart or laptop computer Scribe

Academic Accommodations andRecommendations

Homework: Voice recognition or mind-mapping software Shorter assignments/assignments broken down into

shorter sections with intermediate due dates Not counting mechanical/spelling errors

Handwriting: Pencil grips PAL handwriting lessons (primary grade students) or

explicit handwriting instruction Eliminate requirements for cursive writing In math, using graph paper to line up numbers

Homework Tips Encourage your writer to map out ideas (prewriting

strategies) There are software programs to help such as

Kidspiration and Inspiration Provide a homework area that is well organized at a

table or desk and not on a bed. Reinforce that the first writing attempt is a draft.

Writing is a mult-step process. Develop strategies to help your child to self-monitor

their work. In partnership with your child, develop a writing process checklist.

University of Washington Learning

Disabilities Center “Mantra”

Imagine ALL the children learning well in school

You may say we are dreamersBut then we are not the only onesWe hope you will join us andThe world will be a better place

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