Week 7 - FINAL Flashcards
Prevalence of learning disorders
15-25%
Hierarchy of cognitive disorders
Neurological Disorders
Developmental Disorders
Learning Disorders (LD, autism, intellectual disability, ADHD)
Specific learning disabilities
How many recognized learning disabilities are there
7
The recognized learning disabilities are there
- speech disorder
- language disorders
- reading disorders
- mathematics disorders
- ADHD
- Autism spectrum disorders
- intellectual disability
Is written language disorder a learning disability?
NO! There is no evidence for written language disorder
Diagnosing learning disabilities in the U.S.
- Discrepancy model (exclusively nomothetic, aka exclusively based on test scores)
- Responses to intervention (RTI) (largely idiographic- intensive study of a single person or case in order to obtain an in-depth understanding of that person or case)
- Pattern of Strengths and Weaknesses (PSW) (nomothetic and idiographic)
Discrepancy model
Significant differences between cognitive aptitude and achievement
State laws specify the required discrepancy to diagnose (a standard deviation or two computed from a regression equation)
Achievement tests: Batteries
Batteries
- woodcock-johnson achievement test
- Wechsler individual achievement test (WIAT)
- wide range achievement (WRAT)
Achievement tests: focal achievement tests
Focal achievement tests:
- Comprehensive test of phonological processing
- Nelson denny reading tests
- Gray oral reading test
- Key math test
Colorados law on diagnosing learning disorders
Colorado statues use a regression model to specify cutoff values for diagnosis (AKA uses the discrepancy model)
BUT for public schools, federal law prescribes RTI
Response to Intervention Approach (RTI)
School-based approach
- classroom teachers try different interventions for a child who is falling behind in achievement to see what helps that student
“To identify and address student academic and
behavioral difficulties through effective, efficient,
research-based instruction and progress monitoring in
a multi-tiered intervention model”
Assessment in RTI steps
Level 1 – screening
Level 2 – instruction supplements focused on non-responders to level 1 interventions
Level 3 – problem-solving
Level 4 – Test for Specific Learning Disorder
- Dx»_space; IEP (could include aids in the classroom, class accommodations)
- 504 (“suspected” specific learning disorder, less intensive than IEP)
Challenges/critiques of RTI
RTI solution of trial and error (some say: waiting to fail) that doesn’t effectively address SLD
- Delay minimum 6 weeks at each RTI level
- high ability students with SLD not identified
- Add big burden to teachers, who then might resist process
- Impact on student self-concept of continued failure (impact of having to try and fail for long periods)
Emerging Consensus on SLD assessment
- Critiques of RTI
- Distinguishing between ability and academic performance is arbitrary and counterproductive
- Field of SLD assessment is transforming
- Efforts to make assessment more consistent with empirical evidence
- Use tests to identify patterns of strengths and weakness superior to discrepancy model
- Importance of other sources of information (history and observation, HOT model)
Importance of following quote:
“Every child is like all children, like some other children, and like no other children.” (Robin Morris)
Understanding and treating depends on group level variation. A science is not possible at the species or unique level.
Like all groups (species level)
Like some groups (diagnostic level)
Like no one (unlike any one else, unique)
Why are diagnoses important
Efficient identification and treatment
facilitates communication
Provides access to supports
Facilitates research
Can be therapeutic in itself
Patterns of strengths and weaknesses Approach to Diagnosing Specific Learning Disabilities
- New foundation for understanding learning disabilities
- strongly grounded in and emerging from research evidence
Diagnosing Learning Disorders: From Science to Practice (2019
Pennington, McGrath & Peterson
“The work of Pennington and colleagues captures
the emerging model of assessment of SLDs by
applying the vast body of research to face the
enormous complexity of SLDs in an evidence-based
approach to assessing and understanding SLDs”
Complicating factors to learning disabilities
Heterotypic continuity
Brain plasticity
Comorbidity
Multiple levels of consideration
- Etiology
- Brain development
- Neuropsychology
- Effects on cognitive ability
Genetic & environmental factors are bidirectional
Heterotypic continuity and SLD
The underlying impairment/disorder is continuous through life but the expression of it is different across age (i.e., symptoms manifest differently with different developmental phases/tasks).
Plasticity of Brain Development and neurodevelopmental disorders
Neurodevelopmental disorders are bidirectional because development is occurring throughout life and the environment also affects brain development (nutrition, experiences, etc.)
Interplay of risk and protective factors
Probabilistic model rather than determinative
Comorbidity
There is more generality than specificity in the cognitive profile of comorbid neurodevelopment disorders
BECAUSE of shared risk and protective factors at the etiological level (the cause of disorder)
(its common, often have multiple)
With a learning disorder, there is a _______ chance of also having ADHD.
20-25% chance of also
having ADHD.
With ADHD, there is a _______ chance of also having a learning disorder.
30-70%
(Everyone who has ADHD should be
checked for a learning disorder – and vice versa)
- With Tourette’s syndrome ______ of children also have a
learning disorder.
~60%
With Conduct Disorder and Oppositional Defiant Disorder about ______ have learning disorders.
one third
Summary Model of
Neurodevelopmental Disorders
(Pennington, McGrath & Peterson)
- etiology (cause) of behaviors is from multiple sources (including interaction of risk and protective factors which can be either genetic or environmental)
- risk and protective factors change neural development which impacts important cognitive functions. These impact development which we see in behavioral symptoms.
- No single etiological factor is sufficient for a disorder
- comorbidity of complex behavioral disorders is expected because of shared etiological and cognitive risk factors (a lot of disorders have similar reasons for developing)
- Liability distribution for a given disease is continuous and quantitative, not discrete and categorical, so threshold for having a disorder is somewhat arbitrary (diagnosis is arbitrary because disorders are continuous and quantitative, not discrete)
Holistic approach to diagnosis of LD
both nomothetic and ideographic
- consider context (family, school, community)
- Evaluate the full picture (including social, emotional, behavioral)
- Use multiple sources of info – HOT (history, observation, tests)
History in HOT model
Family history (dx, difficulties in school)
Developmental, medical, and educational history
Records that are available reflecting school performance and any previous assessment results
Psychosocial history (emotional etc.)
Sleep patterns (growing evidence this is a factor)
Observations in HOT model
Begins with first contact
Classroom/work observation
Vicarious Observation (parents and teachers)
Testing Observations (cooperation and effort; problem solving approach; types of errors made)
Tests in HOT Model
Flexible battery approach
- Areas most relevant to LD
- Emotional screen
Performance validity tests are widely used to
determine the client’s level of motivation (research shows judgement alone is not enough)
