Dyslexia: Differentiating Myth from Research

Matthew Burns

University of Missouri

Dyslexia• Dyslexia is a specific learning disability• Neurobiological in origin• Characterized by difficulties with accurate and/or fluent word recognition and

by poor spelling and decoding abilities• Difficulties typically result from a deficit in the phonological component of

language– Often unexpected in relation to other cognitive abilities– Often unexpected given the provision of effective classroom instruction

• Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth of vocabulary and background knowledge

• International Dyslexia Association and the National Institute of Child Health and Human Development (NICHD)

Dyslexia

• In 1880s it was Word Blindness

– Believed to be visual

• Term first used in 1930 by physicians

– “dys” absence and “lexia” language

Identifying Dyslexia

Early Warning Signs - Myths• Preschool

– May talk later than most children

– May have difficulty pronouncing words, i.e., busgetti for spaghetti, mawn lower for lawn mower

– May be unable to recall the right word

– May have trouble interacting with peers

– May be unable to follow multi-step directions or routines

– Fine motor skills may develop more slowly than in other children

Early Warning Signs - Myths• Early Elementary

– Letter reversals – d for b as in, dog for bog– Word reversals – tip for pit– Inversions – m and w, u and n– Transpositions – felt and left– Substitutions – house and home– May transpose number sequences and confuse arithmetic signs (+ - x / =)– May be impulsive and prone to accidents– May have difficulty planning– Often uses an awkward pencil grip (fist, thumb hooked over fingers, etc.)– May have trouble learning to tell time– May have poor fine motor coordination

Early Warning Signs• May be slow to add new vocabulary words• May have difficulty with rhyming• May have trouble learning the alphabet, numbers, days of the week, colors,

shapes, how to spell and write his or her name• May have difficulty telling and/or retelling a story in the correct sequence• Often has difficulty separating sounds in words and blending sounds to make

words• Seems to be unable to recognize letters in his/her own name• Has difficulty decoding single words (reading single words in isolation)• May be slow to learn the connection between letters and sounds• A family history of reading and/or spelling difficulties

The Great Compromise• A severe discrepancy between the students apparent potential for learning and his

or her low level of achievement.– Below average for age

– Below expected levels based on ability

• One or more areas– Oral Expression

– Listening Comprehension

– Written Expression

– Basic Reading Skills

– Reading Comprehension

– Mathematics Calculation

– Mathematics Reasoning

SLD Identification

IQ = 10297 102

Reading = 8678 94

IQ = 8075 85

Reading = 7567 83

Lisa

Bart

The Federal Regs.• §300.307 Specific learning disabilities.• the criteria adopted by the State—• (1) May prohibit the use of a severe discrepancy between intellectual ability and

achievement for determining whether a child has a specific learning disability as defined in §300.8;

• (2) May not require the use of a severe discrepancy between intellectual ability and achievement for determining whether a child has a specific learning disability as defined in §300.8;

• (3) Must permit the use of a process that determines if the child responds to scientific, research-based intervention as part of the evaluation procedures described in §300.304; and

• 4) May permit the use of other alternative research-based procedures for determining whether a child has a specific learning disability as defined in §300.8.

DSM – 5 (APA)• Specific Learning Disorder – Reading, not dyslexia.a. Difficulty in at least one of the following areas that has persisted for at least 6 months

despite the provision of extra help or targeted instruction – (a) inaccurate and slow reading, (b) understanding meaning of what is read, (c) spelling, (d) written expression (grammar, punctuation or organization), (e) understanding number concepts, facts, or calculation, and (f) mathematical reasoning.

b. The affected academic skills are substantially and quantifiably below those expected for age and cause impairment in academic, occupational, or everyday activities

c. Onset during the school-age years, although may not fully manifest until young adulthood in some individuals

d. Intellectual Disabilities, uncorrected auditory or visual acuity problems, other mental or neurological disorders or adverse conditions (psychosocial adversity, lack of proficiency in the language of instruction, inadequate instruction) must be ruled out before a diagnosis of SLD can be confirmed.

Sensitivity = .73 (K) and .70 (1st)Specificity = .71 (K) and .88 (1st)

Screening

Shaywitz Scale Results

• 100 students at each grade are identified as at-risk for dyslexia

– 66 to 88 false positives (K) or 46 to 77 (1st)

– 2 to 7 false negatives (actually dyslexic) for each grade

Dyslexia Guidelines• Phonological awareness• Phonemic awareness• Letter naming fluency• RAN• Alphabet knowledge• Sound symbol• Spelling• Fluency• Comprehension

Dyslexia Guidelines• Phonological awareness

– Phonemic awareness– Alphabet knowledge– Sound symbol– Spelling

• RAN– Letter naming fluency

• Fluency• Comprehension

Dyslexia GuidelinesSkill

• Phonological awareness

• RAN

• Fluency

• Comprehension

Measure

• ISF = PA, PSF = PA

• NWF (Word Attack), LSF

• LNF

• DORF

• MAZE – EasyCBM is better, Star

Dyslexia Process• Screen with PA for kindergarten

• Screen with decoding for first grade

• Screen with DORF for 2nd – 5th

– Low accuracy (93% 1st – 3rd, 95% 4th and 5th) = low decoding

– Assess NWF or WA for kids who score low

• Screen with comprehension for MS and HS (use DORF or decoding if low)

What About Spelling• Spelling = decoding

• Terrible screener

– Kids with low decoding are poor spellers, BUT

– Bunch of kids who are poor spellers who decode fine

• Good diagnostic

• WTW (already have it then use it)

WRCStudent 1 38Student 2 122Student 3 126Student 4 82Student 5 102Student 6 77Student 7 51Student 8 84Student 9 80Student 10 102Student 11 83Student 12 48Student 13 104Student 14 152Student 15 143Student 16 115Student 17 142Student 18 114Student 19 13Student 20 75Student 21 141Student 22 87Student 23 49

Median 87

Fall 70

Winter 91

Spring 109Which kids most likely have dyslexia?

WRC WRC after PALSStudent 1 48 92Student 2 122 142Student 3 126 147Student 4 82 113Student 5 102 117Student 6 77 97Student 7 51 70Student 8 84 95Student 9 80 82Student 10 102 127Student 11 83 106Student 12 38 47Student 13 104 115Student 14 152 161Student 15 143 158Student 16 115 125Student 17 142 160Student 18 114 127Student 19 13 40Student 20 75 92Student 21 141 136Student 22 87 105

Student 23 49 47

Median 87 113

@burnsmk1burnsmk@missouri.edu