H860 Reading Difficulties

Week 8

RD and Other Acronyms

Today’s session

1. Next week’s memo2. Intervention presentation3. Break4. HI, SLI, EF etc.

Next week’s memo

Goal: To engage with readings in an inclusive, interactive way

Step 1. Submit to the website dropbox 1 paragraph that responds to one of the articles with either:

1. An interpretation of the week 9 readings using previous readings/theories

2. An extension of ideas from readings to practice/own experiences3. An unanswered question

Next week’s memo

- use APA reference-style within paragraph but no need for reference list at end

Step 2.

- in the following week you will be able to see the group’s postings and you will write a reaction paragraph to an individual response or emergent theme

- 4 points will be given for 1st paragraph (1 for completing readings, 1 for style, 2 points for content), 2 points for the reaction paragraph

Next week’s memo

• Additional reading:

Falik, L. (1995) Family Patterns of Reaction to a Child with a Learning Disability: A Mediational Perspective. Journal of Learning Disabilities, 28, 335-341.

Today’s feature presentation…

Break

Influencing factors on Literacy

• Speech and Language Difficulties• Hearing Impairment• Executive Function Difficulties

Concept:

Semantics:

Morphology/syntax:

I (subject) wish (present tense verb) the (determiner) summer (noun) would come (subjunctive)

Phonology:

Pragmatics:

has summer got agency?

Speech and language

& Articulation

Speech vs. language

• ‘Speech’ – articulation, phonology and phonological awareness

• ‘Language’ – semantics (includes vocabulary), syntax, pragmatics

Why do children have speech/language problems?

Known causes e.g.:

• Perinatal conditions such as maternal drug abuse• Neonatal factors such as premature birth or low birthweight• Physical/sensory differences at birth• Presence of many genetic syndromes e.g. Down Syndrome,

fragile X syndrome, Williams syndrome• Environmental factors e.g. maternal mental health

difficulties, neglect

Unknown causes:• Specific language impairment (SLI)

How do speech difficulties affect reading?

• More impact at the early stages: decoding• ‘Critical age’ hypothesis• Presence of poor phonological awareness is most

important – children can have articulation/phonology difficulties in the presence of good PA – this group less at risk

Typical 4 year old speech

Delayed 4 year old speech

http://www.youtube.com/watch?v=jUTArv306V4&feature=related

http://www.youtube.com/watch?v=w1pe9CLVZwA&feature=RecentlyWatched&page=1&t=t&f=b

How do language difficulties affect reading?

• More impact in later stages: fluency and comprehension

Hayiou-Thomas and Snowling

Hearing Impairment

• A specific speech and language profile

• Some background:

- Conductive vs. sensori-neural hearing loss - Increase in number of students

with cochlear implants

Teaching Environments

Teaching environment for children with hearing impairment is evolving and controversial.

Historically, schools for children with HI were aural relying on spoken language, speech-readingNow Total Communication is more common which relies on a combination of number of modes of communication such as signed, oral, auditory, written and visual aids, depending on the particular needs and abilities of the child.

Also Bilingual-Bicultural schools where ASL is primarily used as the foundation for written language learning

The path to reading…

It is still unclear if one path is better than anotherbut given the undeniable impact of HI on phonological skills, language competence in either ASL or spoken English will be crucial for optimizing reading outcomes

Executive Function

• What is it?

“Executive function is an umbrella term that incorporates a collection of inter-related processes responsible for purposeful, goal-directed behavior.”

(Gioia, Isquith, & Guy, 2001)

Processes involved with EF

• Goal • Plan • Sequence • Prioritize • Organize • Initiate • Inhibit • Pace • Shift • Self-monitor • Emotional control • Completing

EF

• Previously assessed primarily by neuropsychologists• More recently it has moved to domain of psycho-education as

contributions to academic achievement are being recognized

• An orchestra conductor is a commonly used analogy…

…however more likely there are a team of conductors

‘Hot’ and ‘Cool’ Executive Functions

• ‘Cool’ EF is used in relatively abstract, decontextualized problem-solving e.g. organizational and memory search strategies, impaired set-shifting- linked to dorsolateral prefrontal cortex

• ‘Hot’ EF is required for problems with high affective involvement/significance and empathic, socially and civically appropriate behavior- linked to orbital and medial prefrontal cortex- much less understood than ‘cool’ functioning

EF Difficulties

• Difficulties with executive function are common consequence of many different developmental disorders, but different developmental disorders may involve impairments in different aspects of executive function:

– Only children with ADHD seem to have special difficulty with tasks that require them to suppress overlearned responses, such as the Stroop Task and the Stop Signal Task.

– In contrast, children with autism, but not children with ADHD, seem to have special difficulty with cognitive flexibility, measured by card sorting tasks such as the Dimensional Change Card Sort (DCCS) and the Wisconsin Card Sorting Test.

Stop-Signal Task

• Race between response generation/execution and response inhibition

• ‘Go’ task on every trial – speeded forced choice reaction task

• ‘Stop’ task occurs randomly and infrequently that countermands go response

EF in school

Signs of EF difficulty

Taken from http://www.schoolbehavior.com/

Signs of EF difficulty, cont’d

Taken from http://www.schoolbehavior.com/

EF in Reading

• Reading Decoding – poor use of one or more EFs (e.g. lack of attention to specific letters on words; saying words that “look” like the word on the page)

• RAN – poor executive control of language fluency processes

• Reading comprehension – poor direction of one or more self-regulation EFs e.g. focus, sustain, manipulate, balance etc.

EF in writing

• Poor organization of written material• Poor retrieval cueing or poor generation/fluency

of ideas• Inability to use multiple self-regulation EFs at one

time (e.g. hold, manipulate, retrieve, generate and execute)

EF in Math

• Poor monitoring and correction when doing calculation routines

• Poor use of organize, store, retrieve, execute when learning or applying rote knowledge

• Poor use of hold, organize, manipulate and retrieve when setting up calculations or problems

EF assessments

• EF Battery TestsNEPSY (Attention-Executive Functions Domain)Behavioural Assessment of Dysexecutive Syndrome

• Individual subtestsWisconsin Card Sorting Test (WCST)Rey Complex FigureConnor’s Continuous Performance TestStroop Test

http://aboutkidshealth.ca/News/Executive-Function-Part-One-What-is-executive-function.aspx?articleID=8024&categoryID=news-type

Environmental and Behavioral Functioning

Behavioral Rating Inventory of Executive Function (BRIEF)

• Global Executive Composite• Behavioral Regulation Index

– Inhibit – Shift– Emotional Control

• Metacognition Index– Initiate– Working Memory– Plan/Organize – Organization of Materials– Monitor

BRIEF

• Teacher report, parent report and self-report for older children

• BRIEF is most widely used in schools but can often over-estimate impairment

DSM-IV Criteria for ADHD

I. Either A or B:

A. Six or more of the following symptoms of inattention have been present for at least 6 months to a point that is disruptive and inappropriate for developmental level:

Inattention

1. Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.

2. Often has trouble keeping attention on tasks or play activities.

3. Often does not seem to listen when spoken to directly.

4. Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand

instructions).

5. Often has trouble organizing activities.

6. Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).

7. Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools).

8. Is often easily distracted.

9. Is often forgetful in daily activities.

B. Six or more of the following symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level:

Hyperactivity

1. Often fidgets with hands or feet or squirms in seat. 2. Often gets up from seat when remaining in seat is

expected. 3. Often runs about or climbs when and where it is not

appropriate (adolescents or adults may feel very restless).

4. Often has trouble playing or enjoying leisure activities quietly.

5. Is often "on the go" or often acts as if "driven by a motor".

6. Often talks excessively.

Impulsivity

1. Often blurts out answers before questions have been finished.

2. Often has trouble waiting one's turn.

3. Often interrupts or intrudes on others (e.g., butts into conversations or games).

4. Some symptoms that cause impairment were present before age 7 years.

5. Some impairment from the symptoms is present in two or more settings (e.g. at school/work and at home).

• There must be clear evidence of significant impairment in social, school, or work functioning.

• The symptoms do not happen only during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder. The symptoms are not better accounted for by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).

Based on these criteria, three types of ADHD are identified:

ADHD, Combined Type: if both criteria 1A and 1B are met for the past 6 months

ADHD, Predominantly Inattentive Type: if criterion 1A is met but criterion 1B is not met for the past six months 

ADHD, Predominantly Hyperactive-Impulsive Type: if Criterion 1B is met but Criterion 1A is not met for the past six months.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.