Transcript LD_Assessment_updated_11-11

A Review of Learning Disorders
and It’s Impact on Individuals and Others
Staff Training
Ken Kosko
Education Evaluation Center
The Teaching Research Institute
Western Oregon University
SLD
Rehabilitation 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.)
SLD
DEFINITION-RSA
Central Nervous System Processes
1. Perceiving
2. Understanding
Spoken or Written Language
Manifestations:
Attention
Reasoning
Memory
Communicating
Academics (reading, writing, math)
Coordination
Social Competence
Emotional Maturity
Oregon Department of Education
Oregon Administrative Rules 9/19/2007
Specific Learning Disabilities
A. Achievement Grades (1-12)
(A) Basic Reading Skills
(B) Reading Fluency Skills
(C) Reading Comprehension
(D) Mathematics Calculation
(E) Mathematics Problems-solving
(F) Written Expression
(G) Oral Expression
(H) Listening Comprehension
Oregon Department of Education
Oregon Administrative Rules 9/19/2007
Specific Learning Disabilities
B. Other: If needed
(1) Cognition
(2) Fine Motor
(3) Perceptual Motor
(4) Communication
(5) Social or Emotional
(6) Perception or Memory
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.
Common Challenges of Successful
Adults with LD
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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)
Everyday Manifestations
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Feeling constantly behind
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Fear of filling out forms
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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
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Slow reader (estimated range up to four times as
long to read a page as others)
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Reading out of sequence (they went to see a
movie=they to see a movie went)
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Mistaking one word for another (for=from, to=of)
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Tracking difficulty: skipping over words or lines
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Difficulty reading multi-syllable words (aluminum)
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Difficulty with sound symbols relations
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Lack of vocabulary understanding & reading
comprehension
Spelling
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Reversals common: d=b, friend=freind, (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
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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
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Seldom able to complete exams in class or
national exams
Difficulty with multiple choice questions; difficulty
filling in the bubbles on forms
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Misinterprets directions or questions on exams
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Extreme test anxiety
Concentration
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Focusing requires extraordinary effort
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Easily distracted by noise and movement
Memory
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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
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Difficulty pronouncing multisyllabic or uncommon
words
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Difficulty reading aloud
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Stuttering or hesitancy in speech
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Difficulty communicating ideas clearly
Orientation
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Difficulty in distinguishing left and right
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Directions, map reading, and navigating difficulty
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Feeling lost in a familiar setting; easily disoriented
Ranges of LD
Journal of Learning Disabilities, 29, 17-30
MILD
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average to above average intelligence
adequate psychological adjustments and
vocational/employability skills
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high academic achievement
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limited processing and language skills
Ranges of LD, cont.
Journal of Learning Disabilities, 29, 17-30
MODERATE
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average to above average intelligence
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some cognitive and language deficits
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one or more academic disabilities
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some psychological adjustment problems
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difficulty with vocational/employment skills
Ranges of LD, cont.
Journal of Learning Disabilities, 29, 17-30
SEVERE
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display below average intelligence
significant cognitive processing and language
deficits
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low academic achievement
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lack of psychological adjustment
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lack of vocational/employment skills
Types of Learning Disabilities
Auditory Perceptual Problems
Auditory Discrimination Problems
The difference between “th” and “f”, “m” and “n”
Auditory Figure-Ground Problems
Hearing over background noise
Auditory Sequencing Problems
Hearing 49 instead of 94 or “treats” instead of
“street”
Types of Learning Diabilities
Visual Perceptual Problems
Visual Discrimination Problems
Trouble seeing the difference between similar
objects (V and U)
Visual Figure-Ground Problems
Trouble seeing a specific image
Visual Sequencing Problems
Trouble seeing things in order
Information Processing and Related
Disabilities
Input
Auditory
Visual
Tactile
Olfactory
Gustatory
Process
Thinking
*Abstract *Concrete
Memory
*Auditory *Visual
*Long Term
*Short Term
Sequencing
Organization
Attention
Output
Talking
Reading
Writing
Motor
*Fine *Gross
Fluency/Speed
Accuracy
Findings of NIH Research in the Area
of Learning Disabilities (1987-97)
Learning disabilities, as they are manifested in difficulties in
school learning, are extremely deleterious to the
development of children and have far ranging consequences
that go well beyond school failure:
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Poor peer relationships
Poor self-efficacy (ability to produce effects or intended
results
Poor post-school adjustments
Juvenile delinquency
Limited occupational status
(Lyon, 1991)
Continuum of Psychiatric Disorders
Possible with Learning Disabilities
– from Dr. Larry Silver
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Internalized
Anxiety
Depression
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Externalized
Oppositional defiant conduct disorder
Borderline personality disorder
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Substance Abuse
Alcohol
Drugs
Common Strengths of Successful
Adults with LD
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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
ADD is most likely caused by a
neurochemical imbalance or
deficiency in the area of the
brain responsible for attention
and activity.
ADD is a neurobiological disability,
frequently characterized by inappropriate
degrees of:
 Inattention
 Impulsivity
 Hyperactivity
It is the neurotransmitters which enable the electrical impulse to be
transmitted from one dendrite to another. Without these
neurotransmitters, the relay of impulses in the brain would be impossible.
The power of determining one’s own behavior is not the power of
one entity (the mind) over another (the body), but the influence the
brain has on itself. In other words, we are our brain.
- Eric Hearth, Researcher
ADD affects 3-5% of the
school-age population, which
means approximately 2.5 to 3
million children in the United
States.
Barkley’s Criteria
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Physical restlessness
Mental restlessness
Easily distracted
Impatient
Hot or explosive temper
Unpredictable behavior
Difficulty completing tasks
Shifting from one task to another
Difficulty sustaining attention
Impulsivity
Talks too much
Difficulty doing tasks alone
Often interrupts others
Doesn’t appear to listen to others
Loses a lot of things
Forgets to do things
Engages in physically daring activities
Always on the go, as if driven by a motor
Diagnostic Criteria for AttentionDeficit/Hyperactivity Disorder (DSM-IV)
A. Either (1) or (2):
(1) Six (or more) of the following symptoms of
Inattention have persisted for at least 6 months to
a degree that is maladaptive and inconsistent with
developmental level:
(a) Often fails to give close attention to details or make careless
mistakes in schoolwork, work, or other activities;
(b) Often has difficulty sustaining attention in tasks or play activities;
(c) Often does not seem to listen when spoke to directly;
(d) Often does not follow through on instructions and fails to finish
schoolwork, chores, or duties in the workplace (not due to
oppositional behavior or failure to understand instructions);
(e) Often has difficulty organizing tasks and activities;
(f) Often avoids, dislikes, or is reluctant to engage in tasks that
require sustained mental effort (such as schoolwork or
homework);
Diagnostic Criteria for Attention-Deficit/
Hyperactivity Disorder (DSM-IV), continued…
(g) Often loses things necessary for tasks or activities (e.g., toys,
school assignments, pencils, books, or tools);
(h) Is often easily distracted by extraneous stimuli; and
(i) Is often forgetful in daily activities.
(2) Six (or more) of the following symptoms of Hyperactivity-
Impulsivity have persisted for at least 6 months to a degree
that is maladaptive and inconsistent with developmental level:
Hyperactivity
(a) Often fidgets with hands or feet or squirms in seat;
(b) Often leaves seat in classroom or in other situations in which
remaining seated is expected.
(c) Often runs or climbs excessively in situations which it is
inappropriate (in adolescents or adults, may be limited to subjective
feelings of restlessness)
(d) Often has difficulty playing or engaging in leisure activities quietly;
(e) Is often “on the go” or often acts as if “driven by a motor”;
(f) Often talks excessively;
Diagnostic Criteria for Attention-Deficit/
Hyperactivity Disorder (DSM-IV), continued…
Impulsivity
(g) Often blurts out answers before questions have been completed
(h) Often has difficulty awaiting turn;
(i) Often interrupts or intrudes on others (e.g., butts into conversations
or games)
B.
C.
D.
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Some hyperactive-impulsive or inattentive symptoms that caused
impairment were present before age 7 years.
Some impairment from the symptoms is present in two or more
settings (e.g., at school [or work] and at home).
There must be clear evidence of clinically significant impairment tin
social, academic, or occupational functioning.
The symptoms do not occur exclusively during the course of a
Pervasive Developmental Disorder, Schizophrenia, or other Psychotic
Disorder an are not better accounted for by another mental disorder
(e.g., Mood Disorder, Anxiety Disorder, Dissociative Disorder, or
Personality Disorder).
Characteristics of ADD Without
Hyperactivity
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Often daydreams of is “lost in a fog”
Is frequently “spacey” or is internally
preoccupied
Is often confused or lost in thought
Often appears to be apathetic or
unmotivated
Frequently is sluggish or slow moving
Often stares
Conduct Problems:
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Antisocial personality (35%+)
Substance/alcohol addiction (25-35% at
adolescence; 10-15% in adulthood)
More frequent moves (3X)
More auto accidents (3X)
More traffic citations (4X)
Police involvement (50%); Court (20%)
Physical Aggression (20% past 3 years)
Emotional Problems:
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Greater suicide attempts (10)
Sexual dysfunction (20%)
Low self-esteem (65%)
Often demoralized
Conditions Often Comorbid with ADHD
Psychiatric Disorders
Oppositional/Defiant Behavior (68%+)
Conduct Disorder (45%+)
Antisocial-Delinquent (25%+)
Anxiety Disorders (0-30%)
Major Depression (0-33%)
Somatization Disorder (24-35% of 12-16 year olds)
Sobering Statistics
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50% retained in a grade at least once
35% never complete a high school
education (Weiss & Hechtman, 1986)
46% had been suspended, often more
than once
11% had been expelled (Barkley et al., 1990)
If Unidentified and Untreated
Increased Risk For:
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Impaired educational performance
Decreased self-esteem
Social problems
Family difficulties
Potential long-term effects
Screening Clients for Learning Difficulties
Referring Clients for Testing
Education Evaluation Center
The Teaching Research Institute
Western Oregon University
Section A
1. Did you have any problems learning in middle school or junior high school?...  Yes  No
2. Do any family members have learning problems?............................................  Yes  No
3. Do you have difficulty working with numbers in columns?................................  Yes  No
4. Do you have trouble judging distances?..........................................................  Yes  No
5. Do you have problems working from a test booklet to an answer sheet?........  Yes  No
Total “yes” answers: ___ x 1 = ___*
Section B
6. Did you have problems mixing arithmetic signs (such as + and x)?................  Yes  No
7. Did you have any problems learning in elementary school?............................  Yes  No
Total “yes” answers: ___ x 2 = ___*
Section C
8. Did you have difficulty remembering how to spell simple words you know?....  Yes  No
9. Do you have difficulty filling out forms?............................................................  Yes  No
10. Did you (do you) experience difficulty memorizing numbers?.........................  Yes  No
Total “yes” answers: ___ x 3 = ___*
Section D
11. Do you have trouble adding and subtracting small numbers in your head?....  Yes  No
12. Do you have problems taking notes?................................................................  Yes  No
13. Were you ever in a special program or given extra help in school? .................  Yes  No
Total “yes” answers: ___ x 4 = ___*
A total score of 12 is seen as high enough
to merit a referral for a full educational assessment.
If the client wants to waive such an assessment,
Be sure they understand what they are waiving
and have them sign below.