The Obstacles to Accurately Identifying a Specific Learning Disability: Limitations of Achievement Test Batteries

Child Study Team (CST) and private practice professionals who are tasked with determining the presence of a specific learning disability (SLD) have acknowledged a growing awareness that limitations of widely used achievement batteries pose an obstacle to accurately identifying the presence of a SLD.

Current achievement test batteries do not adequately mirror the core curriculum used in the classroom. As a result, students who are evaluated to determine eligibility may test out in the Average range despite having significant functional problems in the classroom. For example, students may earn Average range scores on the Pseudoword Decoding subtest of the WIAT-111 but have major problems in decoding. Similarly, that same student may perform in an Average range on the Oral Reading Fluency subtest, but exhibit significant problems with fluency in the classroom.

It is important to remember that the major test batteries offer a sample of academic skills for assessment. When the test material is easier than the core curriculum students are tasked to master, they may be deemed ineligible for support services because of their Average or Above Average range scores. Given this knowledge, professionals at school and even privately may wish to consider testing that is more geared to the curriculum. Moreover, following the general principle of amassing multiple data sources, professionals should consider that functional data (i.e. curriculum-based assessment) from the classroom teacher or parent that is different from the testing data should be further investigated. This may mean doing further assessment or formulating an assessment battery from the outset that may give the clearest picture of a student’s strengths and weaknesses. For instance, for the example mentioned above, using the Comprehensive Test of Phonological Processing to assess phonemics and the Gray Oral Reading Test to measure fluency (i.e. accuracy and efficiency) will provide more comprehensive data and present students with test material that is more challenging than either the WIAT-111 or the WJ-IV. Another tool is Easy CBM which measures reading am math skills and is geared to reflect the curriculum.

An interesting phenomenon has evolved as a result of the fact that the core curriculum is in many ways not developmentally grounded. That is, it poses tasks for students to perform that are beyond their developmental maturity. As a result, a participant at a workshop I gave on identifying learning disabilities proposed that another category of learning disability be considered: curriculum-based learning disorder. That is, a learning disorder that has its roots in the discrepancy between students’ developmental capacity to absorb the curriculum and the expectation that they should be able to master it, making them appear to be learning disordered. Are we creating learning disorders as a byproduct of the curriculum?


The Core-Selective Evaluation Process (C-SEP): Further Support for the Pattern of Strengths and Weaknesses Approach (PSW) for Identifying Learning Disabilities

The recent release of “Using the Core-Selective Evaluation Process (C-SEP) With the Woodcock-Johnson IV: From Theory to Practice (Assessment Service Bulletin Number 11,” from Houghton Mifflin was a welcome sight as it provides further support for the use of the PSW model which I have been writing about for the past two years.

C-SEP mirrors the PSW principles espoused by Flanagan, Ortiz, and others as well as the Cross-Battery Assessment (XBA) procedures described by the same authors. Specifically, C-SEP utilizes the WJ IV family of instruments to gather normative data describing students’ neurocognitive profiles. Thus, both the Wechsler and the WJ IV families of instruments are tools available to diagnose a learning disability. Both approaches utilize similar principles: (1) students would have had to receive appropriate instruction to rule out lack of instruction as a variable; (2) multiple sources of information (i.e. curriculum-based assessment, grades, work samples, test scores) must be sought in justifying a referral for testing and developing a hypothesis that drives the assessment process; (3) linkages between identified processing and achievement deficits must exist; and (4) other factors (i.e. physical or intellectual disabilities; social-emotional disorders; environmental or economic disadvantage, and cultural-linguistic factors) must be ruled out. C-SEP offers its own version of XBA when it is important to expand the assessment of specific findings (i.e. administering another subtest to test out an initial finding is recommended when the WJ IV core administration includes only one subtest in a processing area).

One difference I observed is that the PSW model offers a statistical program to analyze normative data that contrasts findings associated with strengths and those with weaknesses to determine if a statistical difference exists. Moreover, the recent expansion of the PSW software includes hundreds of tests and subtests that may be utilized in performing XBA to give a more comprehensive picture of processing and achievement strengths and weaknesses. PSW also includes measures of executive functions to further elaborate on neurocognitive profiles.

Despite the differences, the road ahead appears to be clear: PSW is being recognized as the primary approach for identifying learning disorders. It is now up to legislators and departments of education in states like New Jersey to acknowledge that PSW reflects the best science we have and give child study teams “permission” to move away from the antiquated and flawed eligibility criteria in the current state code.


The Important Functions of Resistance: What Parents, Teachers, and Therapists Need to Know

Parents, teachers, therapists, and employers are often frustrated by the tendency of individuals with whom they must interact to resist doing what is being asked of them, especially when it is clear that being compliant is in their best interest. On the surface, resistances do not seem to make sense. What is the benefit of students not doing their homework or not studying for exams? Why do employees choose to deflect work assignments or fail to follow procedures or rules? The consequences for being non-compliant can be great. It just doesn’t make any sense.

Understanding the survival and communication functions of resistances helps to decipher these seemingly annoying resistances. In fact, for some individuals, not being resistant holds greater personal consequences. Here is what you need to know about resistances.

First of all, resistances are a natural part of human behavior. They have a survival function-i.e. they preserve the ego of the individual by deflecting that which is threatening-which supersedes the more apparent consequences of not doing something. For example, students who find the academic challenges daunting and feel a lack of mastery will find ways to deflect assigned tasks not because they are being oppositional, but, instead, to preserve themselves from the narcissistic assault of not being able to perform as expected. While not trying or not doing holds its own consequences, choosing not to perform with the purpose of shielding one’s ego from the terrifying prospect of failure may be a better alternative or a lesser evil.

Second, resistances have a communication function. The manner in which individuals resist doing something communicates how best to approach them. (Yelling and screaming do little other than getting temporary compliance). Deciphering the function of resistances may require reinforcing the resistance rather than trying to break through them. While reinforcing a resistance may sound “crazy,” it is important to remember that resolving resistances first requires the willingness to consider the following: (1) individuals choose behaviors, even when they seem unreasonable and illogical, for good reasons; (2) understanding the reasons for resistance communicates a readiness to see the others’ perspective; and (3) an unwillingness to consider another’s perspective makes that person unavailable to hear what you have to say.

Here is an example of a common resistance and how tolerating the induced emotions emanating from the resistance and taking the time to understand the functions of the resistance evolve into a strategy for resolving the resistance. Children and adolescents who are coerced by their parents to seeing a therapist may harbor a deep resentment that is expressed by behaviors rather than words that reflect their unwillingness to cooperate with their parents’ plans. That is, they may attend visits, but not speak or engage in repetitive behaviors or oppose in any way possible the efforts of therapists who are viewed as parental surrogates. The power of the resistance may be experienced by parents and therapists alike as frustration and anger-the same feelings the child is experiencing as a result of being forced to do something he or she does not want to do. When the adults allow themselves to tolerate and experience these unpleasant emotions, they can examine and realize they have a communication function. They scream out, “I am not going to cooperate with you!” Recognizing this, therapists can put these unspoken emotions into words, giving the child the experience of being understood. The therapist then becomes someone of value because he/she has deciphered the behavioral resistance. Taking it further, verbalizing this question-“Don’t your parents realize you have no intention of cooperating with them?”-opens up the opportunity for a dialogue about all of the unfairness the child has felt in relation to the parent. Putting the resentment into words starts to melt the resistance as words become the medium of communication instead of behaviors. The therapy can then begin.

To put this another way, resistances are needed to understand the obstacles to individuals’ willingness to perform or behave in ways that express cooperation rather than opposition. What is also needed is a patient interpreter of resistances to do the deciphering and translate what is learned into an emotional communication that helps the resistant individual to move progressively forward rather than stay trapped in an endless repetitive behavioral cycle.

The Neurocognitive Basis for Learning Disabilities and Executive Function Deficits: A Primer for Parents

To understand the obstacles to students’ learning and performance success, you need not look any further than their processing ability and executive function profiles. The key here is to remember that academic subjects are composed of groups of processing abilities that are, in turn, linked with specific executive functions that serve the purpose of cueing or directing the activation of those abilities in the service of performing a task. For example, the primary processing abilities that are part and parcel of reading include phonemic awareness/auditory processing, orthographic/visual processing, nonverbal reasoning (for inference and comprehension), and long-term memory. The executive functions that support the processing abilities involve activation to work, establishing and sustaining a focus, inhibiting the urge to respond to something other than the reading assignment, adequate processing speed, and shifting to allow movement from one part of the reading assignment to another. Any breakdowns in either the processing skills or executive functions will result in reading difficulties.

The strength of a neurocognitive approach lies in breaking down the primary ability areas further into the narrow abilities that comprise each domain. Here is where the detective work begins. For example, language processing is a primary ability area. It is not sufficient to obtain a score from tests on just this primary ability area because within the domain of language processing there are various narrow skills that may be responsible for students’ difficulties. For instance, lexical knowledge is a narrow ability that encompasses the fund of acquired vocabulary a student has stored in long term memory. It is not uncommon for many students to have average or above average ability in this narrow ability area. Yet, in another narrow ability area, verbal reasoning, which is the skill needed to think and write in a more abstract way, these students falter. Thus, they would do better on vocabulary and spelling tests which rely on rote memory, but struggle when it comes to reading comprehension and making the inferences involved in more conceptual thinking.

Getting to the bottom of students’ learning problems requires this kind of detective work which can be thought of a peeling back the layers of an onion where the starting point are the primary abilities in the top layer and then going further to the layers underneath to get to the narrow ability areas that can be interfering with learning and performance.

Similarly, analyzing the many executive functions-brain processes that cue and direct the activation of the abilities-is of equal importance. For example, there are students whose academic abilities are sound. However, deficits in executive functions like attention, activation to work, or inhibition may leave them adrift, relegated to “spacing/zoning out” and to frequent periods of distractibility, all of which causes them to miss out on instruction. Another common problem occurs when students with an adequate vocabulary are unable to generate an adequate amount of verbiage because of problems with the executive function of planning and organization when faced with demands in producing narrative writing. Thus, these students do not have a learning problem (i.e. a learning disability), but have an executive function deficit (i.e. a producing problem). Writing is a complex skill where executive function deficits in the form of students being unable to get the ideas in their heads onto paper are a common complaint.

The most comprehensive and scientifically valid approach to investigating ability and executive functioning deficits is a neuropsychological evaluation. This kind of assessment not only identifies students’ patterns of strengths and weaknesses, but links these to accommodations and instructional practices that target these specific areas. Generating concrete and practical strategies that target a students’ weaknesses offer teachers, parents, and tutors with the most effective ways to address learning and performance problems.

When Students Don’t “Get It”: Is it Auditory Processing Speed, Listening Comprehension, or Slow Retrieval?

Students who are unable to keep up with orally presented information are often experiencing problems with auditory processing speed. This may be manifested by difficulties simultanenously listening and taking notes, not remembering multi-step directions, needing information to be repeated, and, at times, asking questions or making comments that may have nothing to do with what is being discussed or presented. They often present with a “deer-in-the-headlight” look. That is, information is passing them by much more quickly than they can process it.

Sometimes slow auditory processing speed is accompanied by deficits in listening comprehension or receptive language so that they are unable to comprehend what is being discussed. This kind of problem is often due to a weakness in the amount of vocabulary and overall language that has been acquired so that students actually do not understand the language itself. Weak vocabulary is a common consequence with students who have difficulty reading or do not like to read, diminishing the amount of vocabulary they have encoded.

Another variation are students who may have acquired an adequate store of language, but have very slow retrieval speed. Consequently, they cannot recall vocabulary definitions or verbiage quickly enough from long term memory to process orally presented information efficiently.

The best way to understand which of the above (or what combination of processing deficits) are implicated is to conduct a comprehensive neuropsychological evaluation. This type of evaluation can differentiate between problems with auditory processing speed, receptive language deficits, and slow retrieval of information from long term memory. Once the problem is understood, accommodations and instructional strategies can be prescribed.

Some possible accommodations and instructional strategies for slow auditory processing speed are to slow down the presentation of information and/or present it in smaller segments. This may be accompanied by the use of visuals like graphic organizers to use a multi-sensory approach. Notes can be supplied and a smart pen may be used to capture information that may be transcribed to a computer.  Having students repeat information to make sure they “got it” can also help as well as giving directions in short, concise statements without adding any excessive language to process. Using a cloze procedure may also help to jog long term memory.

Listening comprehension problems have to do with understanding language and in some cases supports may be added to build vocabulary and apply it in oral and written expression.

It is most important not give students with these deficits the feeling that they are not smart. Teachers and parents need to regulate their emotional responses when their students do not get it or make responses that are out of context. This is hurtful and damaging. Instead, consider investigating the source of these types of responses with an open mind without rushing to judgment. There are always strategies to help.

The Importance of Differentiating Instruction for Success

Differentiating instruction may be the key to academic success for many students whether they are classified or in the mainstream. The principle behind differentiation is simple: different students process information and learn in different ways and it is important that teachers adapt the content, process or format to match the varying learning styles of their students. For example, some may be visual learners while others do best when material is presented in a verbal format. However, in the fast-paced, curriculum driven atmosphere of education today, there often exists a one size fits all way of presenting instruction and instructional materials. In addition, while lip service is often given to the importance of differentiating, many teachers have not received sufficient training to adequately adapt to the differences in the student body. Moreover, some consider differentiation something you do only for special education students. What about the differences in the wider population of general education students in the mainstream?

Differentiating begins by teachers assessing what each student actually knows about a particular content area. Next, it is of equal of even greater importance to understand how students process information. The example above about verbal vs. visual learners is just one of many different pieces of information that may guide teachers in determining how to present instructional materials. Sometimes the content is varied so that different students have different kinds of tasks to perform within the same academic subject. At other times, the same information is presently differently to different students. Another variable to consider is students’ interests. If teachers know that certain students have specific content area interests or are mobilized by music or movement, then these elements can be built into instruction to capture and maintain students’ motivation.

It is not uncommon for teachers and parents to need to seek out more specialized ways of assessing either student’s depth of acquired knowledge or their individual style of processing information. The most thorough way of accomplishing these tasks is to utilize a comprehensive psycho-educational or neuropsychological evaluation. These types of assessments focus in on measuring students’ knowledge base and information processing skills. Moreover, the results of these evaluations can be directly translated into instructional strategies which teachers and parents can use to give their students the best opportunity for academic success. A good evaluation will provide teachers with information that they may be unable to obtain on their own.

Surviving Your Child’s Academic Struggles: The Value of a Neuropsychological Perspective

One of the most painful and anxiety inducing experiences parents have to endure is when their child is not making it at school. The realization that something is wrong may come about as a result of a call from the teacher or after attempting unsuccessfully to help a child with homework or understanding a concept taught that day at school.

What are parents to do?

First, it is essential to try to contain the worry that is induced by this discovery and even more important to fight the urge to be critical of your student that may result from your well-meaning, but ineffective attempt to help.

Second, it is important to avoid taking steps (i.e. immediately running out and hiring a tutor) without first having some understanding of the specific nature of your child’s problem and what kind of person or professional is the right one to address it. Many tutors are former or current teachers and while they may be competent at teaching a class, they may not have the skills to understand and address your child’s problems. Keep in mind that there is a difference between tutoring to achieve task completion (i.e. homework) and tutoring that addresses the root problem of your child’s difficulties.

What do parents, tutors, and teachers need to know?

-Academic subjects are really just names of groups of abilities that are needed to perform successfully in that subject area. For example, students with reading fluency problems may be experiencing difficulties with auditory/phonological processing, orthographic/visual  processing, long term memory, processing speed, or a combination of the above. WITHOUT KNOWING WHICH UNDERLYING ABILITIES ARE AT FAULT, INTERVENTIONS MAY BE PRESCRIBED THAT DO NOT TARGET THE DEFICITS, PROLONGING THE PAIN AND SUFFERING RESULTING FROM A LACK OF MASTERY OF THE CURRICULUM.

Identifying the root causes of a learning difficulty is best accomplished by a comprehensive neuropsychological evaluation. A competent assessment will scientifically go through the steps involved in diagnosing the presence of ability deficits and construct a tailor made intervention plan to address the problems. This includes helping tutors, teachers, and parents with specific ways to individualize instruction to maximize success.

-Identifying the root causes includes not only an analysis of your child’s ability strengths and weaknesses, but also their executive functions. Executive functions are brain processes that direct the brain to engage your child’s abilities in order to meet task demands. For example, children who procrastinate may have a very high threshold of stimulation needed to activate them.

The key here is: understand before doing. It will save time, money, and psychological pain for you and your child.

To learn more about obtaining a neuropsychological understanding of your child’s problem, click here