Final Prep Flashcards
What are the characteristics of a good report?
- Well written (to maintain credibility of examiner)
- Contains clear findings and specific recommendations based on referral issues
- Does not over-qualify or explain away results
- Geared to the intended audience
- Thoroughly investigates central issues
What are the common sections of a traditional report?
- Identifying information (in the heading)
- Reason for referral
- Background Information
- Behavioral Observations
- Basis of Evaluation
- Test Results: Cognitive function; Personality function
- Summary
- Diagnostic impressions
- Recommendations
What are some notable behaviors that should be observed?
- degree of cooperation
- spontaneous conversation
- concern for correctness
- motor behavior
- reaction to failure
- reaction to praise
What is the purpose of the summary section?
The summary integrates the findings into a comprehensive but concise picture
What is the most important part of the report?
The recommendation section
Some key things to remember in report writing:
- Describe tests rather than name them
(“…on a test that measures the ability to remember…”) - Use specific examples when they would help explain
- Don’t be stuck in one way of presenting data–each report is unique
- Don’t use superlatives
What are some common pitfalls in report writing?
- Poor writing
- Inappropriate detail
- Excessive raw data
- Unnecessary jargon
- Unnecessary abstraction
- Vague language
- Inappropriate generalizations
- Careless use of technical terms
- Recommendations that are impractical/unnecessary
- Exhibitionism
What is the prevalence rate of Learning Disorders?
15-25%
List the hierarchy of cognitive disorders
- Neurological Disorders
- Developmental Disorders
- Learning Disorders (LD, Autism, ID, ADHD)
- Specific Learning Disabilities (e.g., dyslexia)
What are the 7 types of Learning Disorders?
- Speech Disorder
- Language Disorder
- Reading Disorders
- Mathematics Disorder
- ADHD
- Autism Spectrum Disorders
- Intellectual Disability
What are the 3 models/approaches of diagnosing Learning Disabilities in the U.S.?
- Discrepancy Model
- Response to Intervention Approach (RTI)
- Pattern of Strengths and Weaknesses
Describe the 3 characteristics of the Discrepancy Model
- It is exclusively nomothetic
- It is concerned with the significant difference between cognitive aptitude (ability/IQ) and achievement
- State laws specify the required discrepancy in order to diagnose (follows a regression model)
What are the three common Achievement Test batteries?
WJA-IV
WIAT-IV
WRAT-5
What are the four focal achievement tests?
CTOPP
Nelson Denny reading test
GORT
Key Math test
What are the key characteristics of the RTI?
- largely idiographic
- school-based approach (teachers try different interventions to see what helps the child)
Describe the levels of assessment in RTI
Level 1 (Screening): school-wide assessment 3 times a year
Level 2 (Supplements): progress is monitored and ineffective interventions are changed
Level 3 (Problem-Solving): identify why certain interventions have not worked, and improve interventions
Level 4 (Test for SLD): formal testing to dx and determine IEP/504 status for accommodations
Emerging consensus of criticisms on Discrepancy Model and RTI:
- Distinguishing between ability and academic performance is arbitrary and counterproductive
- RTI is a solution of trial and error that doesn’t effectively address SDL
- takes at least 6 weeks at each RTI level
- high ability students with SLD are not identified
- teachers are over-burdened
- impact on student self-concept of continued failure
Why are diagnoses important?
- efficient identification and treatment
- facilitates communication (awareness of basic issues)
- provides access to supports
- facilitates research
- can be therapeutic in itself
What are the characteristics of the Patterns of Strengths and Weaknesses Approach?
- both nomothetic and idiographic
- strongly grounded in and emerging from research evidence
What are some complicating factors in identifying learning disorders?
- heterotypic continuity
- brain plasticity
- comorbidity
- multiple levels of consideration (etiology, brain development, neuropsychology, effects on cognitive ability)
- bidirectionality of genetic and environmental factors
What is heterotypic continuity?
Disorders manifest differently in different age groups. The underlying impairment/disorder is continuous through life but the expression of it is different across age
What are the three important facts about the Plasticity of Brain Development?
- neurodevelopmental disorders are bidirectional because development is occurring throughout life and the environment also affects brain development
- interplay of risk factors and protective factors are salient in LD development
- it is based on probabilistic model rather than determinative
Why is comorbidity common in neurodevelopmental disorders?
Because of the shared risk and protective factors at the etiological level–common developmental pathways for various diagnoses are affected
What are some common comorbidities observed?
- With LD, there is 20-25% chance of having ADHD
- With ADHD, there’s 30-70% chance of having LD
- With Tourette’s, there is 60% chance of having LD
- With conduct disorder and oppositional defiant disorder, there is 33% chance of having LD.
What are three things to remember in holistic approach to diagnosis?
- consider the context (family, school, community)
- evaluate the full picture (social, emotional, and behavioral aspects)
- Use multiple streams of information (History, Observation, Tests)
What are the predictors that those with dyslexia have difficulty with?
- Phoneme awareness
- Rapid serial naming
- Vocabulary
- Verbal short term memory
What are the two types of reading disorders, and how are they defined?
- Dyslexia: impaired basic literacy skills (e.g., inaccurate single word reading, poor fluency and spelling)
- Poor comprehenders: normal single word readers, but impaired reading comprehension (broader language processing problems)
What are the three facts about dyslexia?
- It is one of the most common type of learning disability
- It is found across languages
- It is more severe in alphabetic languages that have inconsistent mapping of letters to sounds (e.g., English) than those that have consistent mapping (e.g., Spanish, Italian)
Which two indices in WAIS/WISC have the highest effect size for those with dyslexia?
WMI (1.10) and VCI (0.84)
Which two indices in WAIS/WISC have the highest effect size for those with LD in math?
PRI (0.80) and VCI (0.61)
What are the three WJ-IV tests and what do they measure?
- Tests of Cognitive Abilities: measures aptitude or IQ
- Tests of Achievement: focused on written skills
- Tests of Oral Language: focused on oral skills
What are some oral language abilities that the WJ-IV Oral Language Tests assess?
- combining sounds into whole words
- breaking whole words into parts
- rapid automatic naming
- associative retrieval of words
What is a way of effectively using the WJ-IV Achievement Test (with their 11 standard battery and 9 extended battery)?
Upon administering the standard battery subtests, consider the cluster(s) that may benefit from further evaluation and administer the extended battery accordingly.
What score should you pay attention to when diagnosing?
Check the SS (standard score) to see if there’s any significant discrepancy that indicates a diagnosis
What is the age range for WIAT-III?
4 to 50yrs and 11mos
What are some characteristics of the WRAT5?
- For ages 5 to 85+
- Fairly short administration time (15-45min)
- Two alternate forms
- Three subtests (which makes it simpler): reading, spelling, math
What is the purpose of focal reading tests?
They focus on a specific deficit
What are some focal reading tests and the deficits that they measure?
- GORT-5: dyslexia
- Nelson Denny Reading Test: comprehension
- Florida Nonsense Passages: phonic-based
What is the key symptom of dyslexia?
Difficulties learning to read and spell, generally apparent from beginning of formal literacy instructions
What are the two main difficulties that virtually all those with dyslexia have?
- Reading aloud
- Learning phonics
What are the three aspects of history in the PSW model?
- Family history (e.g., genetic component)
- School history (apparent by 1st/2nd grade)
- Reading and language history
What are some common observations, in the PSW model, found in those with dyslexia?
- Often report not liking reading or feeling embarrassed to read aloud
- More difficulty in timed tests (than untimed tests) of words and paragraph level reading
What are the 7 error analysis (kinds of mistakes made) found in dyslexia?
- Dysfluency: slow and halting in oral reading
- Errors on functional words (e.g., misread or omit “a” and “the”)
- Visual errors: whole-word guesses based on visual similarity (e.g., tired for tried)
- Lexicalizations: reading a non-word (e.g., clup) as a visually similar real word (e.g., clip)
- Spelling errors
- Reversal errors (e.g., b and d confusion): occurrence in dyslexia is comparatively low, so this sx is not diagnostic
- Unusually quiet because of word finding problems
What is a common projection of heterotypic continuity in dyslexia?
- Early years: difference in speech perception and babbling
- Then vocabulary and syntax
- Then phonemic awareness
What are some helpful considerations in diagnosing dyslexia?
- Early signs do not have enough sensitivity and specificity to diagnose prior to formal literacy instruction
- Tasks emphasizing speed become increasingly important diagnostically
What are two important facts about the etiology of dyslexia?
- Dyslexia is the intersection of an evolved behavior (language) and a cultural intervention (literacy)
- Both genetic and environmental factors contribute to dyslexia
What are three treatments for dyslexia that can be done in early years?
- One-on-one intervention or small groups
- Intensive, explicit phoneme awareness instruction (most important!)
- Supported reading with increasingly difficult text, writing exercises, and comprehension strategies
What are some accommodations that can be given for dyslexia?
- Extra time on test
- Marking but not downgrading spelling errors
- Excused from foreign language requirements
- Oral exams for severe dyslexia
What are some unsupported treatments for dyslexia that should be avoided?
- Visual therapies
- Eye movement exercise
- Colored lenses
- Peripheral reading
- Vestibular medications
- Chiropractic
- Dietary treatment
Why is memory so important in cognitive function?
- Memory is the cornerstone of cognitive function
- Memory is intertwined with all aspects of normal cognition
- Attention and concentration are prerequisite to memory
According to the Multiple Memory Systems, memory can be divided into two types. What are they?
- Explicit (Declarative) memory, such as remembering semantic information or specific events
- Implicit (Procedural) memory, such as learning a new skill
What are two types of memory problems?
- Anterograde amnesia (unable to make new memories)
- Retrograde amnesia (unable to recall past memories)
What are the three subtypes of ADHD?
- Predominantly Inattentive type (.00)
- Predominantly Hyperactive-impulsive type (.01)
- Combined type (.01)
What is the criterion A for ADHD Inattentive type ?
- Often fails to give close attention to details or makes careless mistakes
- Often have difficulty sustaining attention in tasks or play
- Often does not seem to listen
- Often does not follow through on directions (not ODD)
- Often has difficulty organizing tasks or activities
- Often avoids, dislikes task that require sustained mental effort
- Often loses thins necessary for tasks
- Often easily distracted by extraneous stimuli
- Often forgetful of daily activities
What is the criterion A for ADHD Hyperactive-impulsive type?
- Often fidgets or squirms
- Often leaves seat in situation where remaining seated is expected
- Often runs about or climbs excessively when inappropriate
- Often difficulty playing quietly
- Often “on the go,” “driven by a motor”
- Often talks excessively
- Often blurts out answers before question finished
- Often difficulty waiting turn
- Often interrupts or intrudes
What are the criteria B-E for ADHD diagnosis?
B. Some sx that caused impairment present before age 12
C. Some impairment present in two or more settings
D. Clear evidence of clinically significant impairment in social, academic, or occupational functioning
E. Not PDD, Sz, Other Psychotic disorder and not better explained by Mood, Anxiety, Dissociative, or Personality Disorders
What are three facts about the prevalence of ADHD?
- One of the most common chronic disorders of childhood
- Found across social classes, racial and ethnic groups, and countries but with different prevalence rates
- Onset often around 3 to 4 years old
What is the prevalence rate of ADHD in the U.S. and in other countries?
U.S. is about 8-10%
World average is about 3%
How does ADHD sx show up in adults?
Disrupts sustained effort, planning, and organization important for effective functioning
What are some comorbid conditions of ADHD that can be confused with ADHD?
Anxiety, Depression, Dyslexia, Family dysfunction, Conduct disorder, Tourette’s syndrome, Language impairment, Bipolar disorder, Brain injury, Intellectual giftedness
What is the frequency of ADHD comorbidity?
More than half (67% in one study)
What does ADHD sx look like in infancy and preschool years?
-Infancy: high activity, emotional lability, irregular sleep patterns, reduced need for sleep
-Preschool: short attention span, proneness to tantrums, difficulties with groups
How is ADHD diagnosed?
relies on converging evidence from developmental/school history, observations, and testing (HOT)
What are some tests that can be included in ADHD diagnosis?
-Interview, history, school records
-School visit
-Tests WAIS/WISC, WJA/WIAT
-Continuous performance test (CPT)
-MMPI
-Collateral Information (BASC/CBCL, Conners 3, CAARS)
What does the latest research say about ADHD diagnosis?
Cognitive assessment may not be necessary. Rather, behavioral assessment through rating scales (self and vicarious observations) and history may be sufficient (basically, HO is sufficient)
What are some examples of CPT and what are the limitations of the Continuous Performance Tests (CPT)?
- Performance can be impaired for reasons other than ADHD
- Performance can be unimpaired in ADHD
Ex: Conners, TOVA, IVA
What are two general types of Collateral Information and how is it structured?
- Multi-dimensional or broad band
- Unidimensional or focal
It is a behavioral rating scale
What are four types of treatment available for ADHD?
- Educating the client
- Medication (that enhances the inhibition mechanism)
- Accommodations (modify the environment)
- Therapy
What are some medications for ADHD and are they effective?
-Stimulants: Ritalin, Adderall, Vivance
-Non-stimulants: Straterra
And yes, 75-90% show improvement, and ADHD is the only LD that has effective pharmacological treatment for the main symptoms
What are some educational interventions in schools that can help those with ADHD?
- Shorten delay between response and outcome
- Structure the task, make smaller steps, more immediate reinforcement
- Bridge time by breaking task down into manageable intervals
- Increase external cues (e.g., clock, token)
- Minimize distractions
What aspects of cognition/performance does creativity impact?
- Problem solving
- Innovation
- Artistic Expression
- Overall Advancement across fields
Is creativity inherent?
No, emphasis has shifted from seeing creativity as an inherent ability to something that can be enhanced/improved
What are the two tasks of divergent thinking?
- Fluency: number of ideas one can generate; quantity
- Novelty: quality; how original something is
Is divergent thinking plastic or stable?
It has plasticity; studies show fluency and novelty can be improved through medication, diet, walking, music, travel, new experiences, etc
What are three essential skills for assessment?
- Sorting through and making sense of data
- Inference (reasoning from knowledge or evidence)
- Good writing
What are the two ways of making inference for assessment?
- Inductive reasoning: from the details to conclusions; bottom-up
- Deductive reasoning: from conclusions to implications; top-down
What are the four aspects that are impaired in SLD with impairment in mathematics?
- Number sense
- Memorization of arithmetic facts
- Accurate or fluent calculation
- Accurate math reasoning
What are some general factors and specific factors in learning math?
General: g, language, verbal working memory, processing speed, phonological awareness
Specific: number sense (numerosity)
What are two aspects of number sense?
- Approximation: estimating without language or symbols; being able to guess without counting
- Symbolic: representation of precise quantities; digit representation
What are the best cognitive predictors of future math skills?
- General cognitive skills
- Mastery of the exact number system (probably this requires an intact approximate number system)
What cognitive ability is a predictor of MD, RD, and ADHD?
Processing speed
What cognitive ability is a predictor of MD and RD?
Verbal ability
What cognitive ability is a predictor of MD?
Verbal working memory
Describe the general steps of normative math development framework.
- Approximate number system in early infancy (e.g., subitizing)
- Number naming (around 2 to 3 yo)
- Counting (protracted development)
- Recognizing written numbers/symbols
- Recognizing written multi digit numbers
- Automaticity in recognizing printed numbers
- Addition, subtraction
- Memorizing math facts
- Understand place (as they move to multi-digit calculations)
What are some evidence of impaired numerosity?
- Decreased ability to subitize
- Slower reaction time on tests of non-symbolic (approximate) and symbolic (precise) magnitude comparisons
- Small decreases in accuracy of symbolic magnitude comparisons
Is MD heritable?
Yes, MD is familial and heritable; heritability estimate about 0.4
What are the two genetic syndromes that come with MD?
- Turner syndrome
- Fragile X syndrome
What are some HOT items to consider in diagnosing MD?
History
-the course of math difficulties
-the extent of impairment
-familial aspects
Observation
-the process of problem solving (counting strategies, automaticity)
Testing
-general achievement battery
-math achievement test (e.g. Key Math)
-IQ test (g, langue, PS, WM)
How is math anxiety different from MD?
Math anxiety is an emotional response that can have a potential cascading effects of avoidance and becoming more anxious. It can be transmitted intergenerational
What are the three aspects to consider in diagnosing with SLD with impairment in written expression?
- Spelling accuracy
- Grammar and punctuation accuracy
- Clarity/organization of written expression
Written expression includes both _____ and ____
Handwriting and composition
What is an interesting fact about SLD with impairment in written expression?
There is no evidence to support writing disorder as a distinct disorder
What are some behavioral observations of dysgraphia?
- writing is slow (not always messy)
- quality of writing declines under time pressure
- hold pencil awkwardly and tightly
- strokes are not fluid, consistent, or continuous
- poor spatial organization of letters
What are some treatment options for dysgraphia?
- Dx itself can be therapeutic
- Learning to type
- Give additional time for written assignments
- OT (if very impaired)
- Treatment of emotional sequela
What are the key deficits and strengths in Right Hemisphere Learning Disorders?
Deficits:
1. Poor math ability
2. Poor handwriting
3. Poor social cognition (not getting non-verbal social cues)
Strength: Verbal ability
What is the diagnostic code for Right Hemisphere Learning Disorder?
None; it is not in the diagnostic system
What are engram cells?
They are a population of neurons that has gone through persistent chemical/physical changes to become an engram through experience. Subsequent reactivation of the engram induces memory retrieval.
Which aspect of divergent thinking has a better construct reliability for measuring creativity?
Originality
What are some measures of memory?
- WMS
- California Verbal Learning
- Rey Auditory Verbal Learning
- Rey Osterrieth Complex Figure Design
What is a recent trend in neuroscience of human learning?
Understanding types of learning that are supported by neural circuits. This has been made possible through neuroimaging technique, and the hope is to have a better integrated understanding of neuroimaging data and quantitative models of behavior in cog psych.
How long and how many of the criteria A of ADHD need to occur for diagnosis?
6 or more symptoms for at least 6 months to a maladaptive degree
