Effective Intervention Starts with Effective Assessment€¦ · Unit (CHW) NSW Centre for Effective...

Effective Intervention Starts

with Effective Assessment NSW Centre for Effective Reading, Department of Education and Communities

Child Development Unit, The Children’s Hospital at Westmead

Overview of NSW Centre for

Effective Reading Multidisciplinary Assessment

Case Study

Intervention

Questions

The Children's Hospital at Westmead and NSW Department of Education and Communities

CHERI Conference 2013

Principal Palm Avenue School

Principal Royal Far

West

Materials Development

(DEC)

Manly

Steering Committee Oversees strategic direction of the Centre and guides its development

Westmead Wagga Wagga Dubbo

Coordination Group Collaboratively plans and manages the NSW Centre for Effective Reading

Child Development Unit (CHW)

NSW Centre for Effective Reading

Partnerships

ICPA, AECG, RFW, NSW CER, CEC, AIS, NSW TF, MCCS, SCHN



http://www.cer.education.nsw.gov.au/





Response to Intervention

Students’ difficulties persist despite receiving high intensity evidence based instruction. Students require ongoing remediation.

Students not making expected progress despite receiving quality evidence based instruction. Time limited interventions aim to advance students’ progress in line with peers.

Majority achieve through high quality classroom teaching. Systematic phonic work and balanced reading program.

5% of students

Individual Literacy Program

15% of students

Small group - identified students

80% of students typically respond

Best practice teaching

Whole class

Tier 3 Intensive Instruction

Tier 2 Targeted Instruction

Tier 1 Universal Instruction

Diagram adapted from DEC Online training course: ‘Understanding Dyslexia and Significant Difficulties in Reading’



Overview of NSW Centre

for Effective Reading ✓ Multidisciplinary

Assessment

Case Study

Intervention

Questions



Information gathered from the multidisciplinary assessment is discussed and then communicated to all stakeholders. It guides the development of classroom adjustments and individual interventions.

EFFECTIVE INTERVENTION

EFFECTIVE ASSESSMENT

Cognitive

Verbal & Nonverbal

intelligence

Working Memory

Processing Speed

Attention

Executive Function

Learning & Memory

Emotional Health

Background information

Student

Family

School

Medical

Psychosocial

Emotional/social

Education

Phonological Awareness

Phonics (Word Attack)

Sight Words

Fluency

Text Reading

Reading Comprehension

Speech and Language

Receptive Language

Expressive Language

Vocabulary

High Level Language

EFFECTIVE ASSESSMENT Background

information

Speech and

Language assessment Education

assessment

Cognitive

assessment



Psychosocial History

Learning difficulties and comorbid conditions

Medical conditions associated with learning difficulties

Parental perceptions and goodness of fit

Child’s interests and strengths

The Children's Hospital at Westmead and

NSW Department of Education and Communities


•Verbal and Nonverbal Intelligence, Working Memory, Processing Speed

•Informs us of child’s capacity to learn

•Assists teacher interpret reading results and develop/implement appropriate strategies

Intellectual Functioning

•Selective, Sustained, Switching and Divided Attention, Impulse Control, Problem Solving, Planning/Organisation

•Ability to work independently

•Assists teacher develop/implement strategies

Attention and Executive Functions

•Verbal and Visual Memory

•Ability to learn, retain and recall new information

•Assists teacher develop and implement appropriate strategies

Memory

•Anxiety, Depression, Self-concept

•Impacts child’s ability to attend, process information and learn

•Need for psychological support

•Support for self-concept and motivation

Emotional Health

Neuropsychological Assessment





• Reading comprehension

• Word prediction

• Subtle meanings Grammar


• Word prediction

• Reading fluency

• Word decoding

Word Knowledge


• Decoding generally age appropriate (in comprehension only deficit)

Listening Comprehension

• Reading comprehension (inferring, predicting, reasoning)

• Reading accuracy – word prediction

High Level Language Skills

Catts, Adlof, Weismer 2006, Nation et al 2010 The Children's Hospital at Westmead and NSW Department of Education and Communities


• Explicit, intensive instruction in basic reading skills, including phonological awareness, is essential for older, low progress readers (Joseph & Schisler, 2008; Moats & Tolman, 2009).

Phonological Awareness

• Older students are better able to decode and spell words and read text through phonics instruction … including older disabled readers who have already developed reading problems (NRP, 2000).

Phonics

•The ability to read a number of words by sight facilitates reading fluency which impacts on comprehension (NRP, 2000).

Sight words

• Fluency instruction can assist struggling adolescents who are not fluent readers (Rasinski et al., 2005). Fluency

• Instruction in reading comprehension strategies is helpful for all students, particularly for students with learning difficulties (Vaughn, Gersten & Chard, 2000). Comprehension

•Encourage metacognition and make explicit connections between … skills and reading (Hempenstall, 1999; NRP, 2000; NFL, 2010). Connected text

reading

Reading Assessment





Assessment ✓ Case Study

Intervention

Questions




Case Study A 11 year old boy in Year 6

Previous diagnoses:

Attention Deficit Hyperactivity Disorder

Generalised Anxiety Disorder

Low self-esteem

Complex psychosocial history Family history of psychiatric conditions

Previous interventions Small group intervention in class

Intensive reading intervention (non-holistic) outside of school with no improvements

Class teacher reported extreme difficulty in the classroom




Table 2: Summary of cognitive test results for Case Study A

Area of Cognition Extremely Low

≤2

percentile

Borderline

3-9

Percentile

Low Average

10-24

percentile

Average

25-75

percentile

High Average

76-91

percentile

Superior

92-99

percentile

Very Superior

>99

percentile

INTELLIGENCE

Verbal Intelligence

Nonverbal Intelligence

Working Memory

Processing Speed

ATTENTION & EXECUTIVE FUNCTIONS

Selective

Sustained

Switch

Divided

Nonverbal Problem Solving /

Mental Flexibility

Impulse control

Planning & Organisation

LEARNING & MEMORY

Verbal (Structured)

Verbal (Unstructured)

Visual/Spatial

Summary of language test results

Area of Language Severe

Impairment

≤2

percentile

Moderate

Impairment

3-6

Percentile

Mild

Impairment

7-15

percentile

Average

16-84

percentile

Above

Average

116+

percentile

Clinical Evaluation of Language Fundamentals 4

Core Language Index (27)

Receptive Language

Index

(21)

Expressive Language

Index

(32)

Language Content Index (32)

Language Memory Index (32)

The Children's Hospital at Westmead and NSW Department of Education

and Communities CHERI Conference 2013

Test of Problem Solving 3 Elementary

Making Inferences (1)

Sequencing (40)

Negative Questions (2)

Problem Solving (31)

Predicting (1)

Determining Causes (3)

Total Test (3)

Area of Language Severe

Impairment

≤2

percentile

Moderate

Impairment

3-6

Percentile

Mild

Impairment

7-15

percentile

Average

16-84

percentile

Above

Average

116+

percentile

High Level Language





Area of Reading Student: Chronological Age 11y 8m, Year 6

Phonological Awareness 58/60 Segmenting and blending skills good Provides basis for acquisition of literacy skills

Phonics (word attack)

8y 7m

Able to decode to 3 sound/ 3 letter level words, but not apply to reading connected text Demonstrated inconsistent letter-sound knowledge Knows consonant digraphs but not vowel digraphs

High Frequency Sight Words 187/200 early high frequency sight words Supports reading fluency, frees up working memory

Word Identification 8y 2m Well below average range

Not able to readily identify words past early high frequency words Not using orthographic units to support recognition

Fluency Requires further automaticity with word recognition (sight words plus decoding skills) Connected text read at 67 correct words per minute (Year 6 = 100+ correct words per minute)

Comprehension 8y 10m Below average range

Able to answer literal oral comprehension questions but difficulty with inferential and applied oral comprehension

Text reading 8y 3m Below average range

Recognised high frequency words in text, attended to punctuation. Made few self corrections, little evidence of self monitoring

Summary of Reading Assessment




✓

Intervention

Questions




Engaging activities (NRP, 2000; Rose, 2006) combined with corrective feedback and positive reinforcement (Hattie, 1999; Rose 2006) support achievement of goals.

Plan for Reading Intervention

It may not matter who delivers an intervention; what matters more is that an evidence based intervention is chosen that fits the child’s additional needs and that the person delivering it is properly trained and supported (Snowling & Hulme, 2012).



Identifies specific programs and strategies which vary in type and intensity and are selected from a range of research evidence based programs and strategies that are proven to be successful for students with complex reading difficulties.



Plan for Reading Intervention

• Collaboration

• Individual intervention plus classroom adjustments

• Links to syllabus, literacy continuum

• All areas critical for reading instruction

• Knowledge and skills do not change, but the strategies

and their implementation, CAN and DO change



Strategies/programs Student profile

Phonological awareness

Instruction for maintenance in a small group of 3-4 students, use of ipad app ‘Sound

Literacy’.

Auditory memory

Sustained attention

Social skills

Phonics MultiLit Reading Tutor Program: Word Attack Skills http://www.multilit. com/

Synthetic Phonics Program

Best practice literacy instruction as reflected by the reports of the US National Reading

Panel (2000), the Australian National Inquiry into the Teaching of Literacy (2005), and the

UK Rose Report (2006).

Accuracy and fluency (personalise fluency to support slow processing speed)

Decodable texts allow students to practise decoding in context (Al Otaiba et al. 2012;

Center, 2005; Konza, 2011; Rose, 2006).

Decodable texts from SA SPELD (use electronic form) http://www.speld-sa.org.au/

Decodable texts from Phonics Australia – Phonic Books for Older Readers: Totem, Talisman

and Magic Belt Series. Highly structured, cumulative series building up from CVC words.

Designed to appeal to older reluctant readers with exciting and motivating stories and

illustrations. http://www.phonicsaustralia.com.au

Working memory

Processing speed

Planning and organisation

Attention

Anxiety

Self esteem

Poor decoding skills past 3

sound level

Not applying skills to

connected text

High frequency sight words

MultiLit Reading Tutor Program: Sight words http://www.multilit. com/

Overlearn – take known lists home to practise. Need instant and automatic retrieval from

memory. Put cards on curtain ring, changing order to avoid rote memorisation.

Working memory

Anxiety

Self esteem




Vocabulary

Accelerating vocabulary growth is vital and often neglected component of a comprehensive reading

program (Baumann & Kame’enui, 2004)

Preteach vocabulary Build vocabulary instruction into everyday routines Semantic maps Graphic organisers Audio books http://www.mrl.nsw.gov.au/ ‘Vocabulary Dictionary’ facilitates: Meaningful use – students are more likely to develop deep and lasting knowledge of new words if they use the words in meaningful contexts and think actively about what the word means. Multiple exposures – students are more likely to retain new words they learn if they are exposed to them multiple times.

Depth of vocabulary needs

development

Retains pictorial

information

Visual prompts


Poor inferential and applied

vocabulary

Well below average word

recognition

Fluency

Repeated reading of text provides the rehearsal required to build accuracy, speed and confidence, and was one of the major recommendations of the NRP to develop fluency.

Paired reading with peer

Short passages of 50–100 words are preferred so that student can hold within working memory the pattern of the fluent reading modelled.

Phrases written onto sentence strips can serve as visual cue cards, to demonstrate how good readers cluster portions of text rather than saying each word separately.

Working memory

Slow processing speed

Anxiety

Visuals

Decoding not automatic

Word recognition not

automatic

Text reading slow

Vocabulary

Dictionary

Name:


Connected text

Transfer acquired isolated component reading skills into connected text for for

fluency, maintenance and generalisation.

Reading age 8, Interest age 11: Reloaded, fyi (Stranger than fiction true

stories), Reality Check (Fiction stacked with facts)

http://www.barringtonstoke.co.uk/

Match to text level (instructional and independent) Pause Prompt Praise technique, using phonics based prompts. Supported text reading (Modelled, guided, independent) interest texts.

Sustained attention

Executive function

Reading level significantly below

peers

Not transferring skills to

connected text

Comprehension

Teaching students specific strategies, such as how to identify a purpose for reading, will

support executive function difficulties (Carnahan et al. 2012).

Graphic organisers as a prompt to show significant details and to assist with paraphrasing main idea -

builds on strengths in retaining pictorial information (Falk-Ross et al., 2004; Styslinger, 2012; Myles-

Simpson, 2003; Gately, 2008; Griffin et al., 2006).

Inferring

Predicting

Executive function


Anxiety

Sustained attention

Divided attention

Inferential and applied

Classroom adjustments

Task cards for planned cognitive breaks from academic work

Visual checklists for self-monitoring own achievements,

Paced instruction

Personal visual prompts

Executive function


Anxiety

Sustained attention

Divided attention



Value of Multidisciplinary Assessment

Comprehensive assessment equates to a

multidisciplinary assessment

Comprehensive assessment guides individually

tailored intervention

Case Study Acknowledged strengths, areas of need and interests

Individually tailored intervention

Improvements were seen in literacy

Example: Word attack, vocabulary, text reading level and

comprehension







✓

Intervention

✓ Questions










✓

Intervention

✓ Questions

✓ The Children's Hospital at Westmead and








Table 1: Neuropsychological Assessment Battery

COGNITIVE FUNCTIONS ASSESSED TESTS

Intellectual Functioning WISC-IV

Attention TEA-Ch

Focused/Selective Sky Search

Sustained Score

Control/Switching Creature Counting

Divided Sky Search DT

Memory

Structured Verbal CMS: Stories

Unstructured Verbal CAVLT-II

Visual NEPSY-II: Memory for Designs

Executive Functions

Problem Solving/Mental Flexibility WCST

Impulsivity TEA-Ch: Walk Don’t Walk

Planning/Organisation RCF, BREIF (Parent and Teacher)

Executive Behaviours BRIEF (Parent and Teacher)




Speech Pathology Assessments Clinical Evaluation of

Language Fundamentals 4

Australian Standardised

Edition

Test of Problem Solving 3

Elementary

Peabody Picture

Vocabulary Test 4

Receptive Language

(understanding)

High Level Language Skills Receptive Single Word

Vocabulary

• Linguistic concepts

• Syntax (word order)

• Semantics

• Vocabulary

• Extended text

• Making inferences

• Sequencing

• Negative questions

• Problem solving

• Predicting

• Determining causes

• Surface vocabulary

Expressive Language

(spoken)

• Syntax

• Semantics-meaning

• Morphology

• Vocabulary




Sutherland

Phonological

Awareness

Test-Revised

Woodcock

Reading

Mastery

Test -

Revised

Dalwood

Spelling

Test

MultiLit RTP

Word Attack

Skills

(Revised)

Placement

test

MultiLit

RTP Sight

Words

(Revised)

Placement

test

Levelled

text e.g.PM

Benchmark

Reading

Assessment

Decodable

text e.g.

NSW CER

Records of

Reading

Standardised test

which measures

phonological

knowledge that is

typically

acquired in the

first three to

four years of

schooling. Ability

to attend to,

identify and

manipulate the

sounds in spoken

words. The two

critical skills are

blending and

segmenting.

Norm-

referenced

assessment

that measures

several aspects

of reading:

word

identification,

word attack,

passage

comprehension

Standardised

test of spelling

achievement

for students

from

Kindergarten to

Year 10. Links

to phonological

and word

attack skills.

Assesses letter-

sound

knowledge and

blending skills

(single letters

and letter

combinations

and application

of this

knowledge to

read unfamiliar

words.

Assesses 200

words that

have been

identified as

being high

frequency

words in the

reading

material of

primary aged

students.

Application of

these isolated

skills in the

context of

connected text.

Their fluency of

application will

have an impact

on student’s

ability to

comprehend

the text which

is being read.

Specially

constructed

short texts

made up of

words that

students can

decode and

high frequency

sight words that

have been

taught

simultaneously.

Literacy Assessments

* Also available: York Assessment of Reading for Comprehension (YARC), Test of Word Reading Efficiency (TOWRE)




Nation. Kate Cocksey. Joanne, Taylor. Jo S.H., and Bishop. Dorothy V.M. ,

A longitudinal investigation of early reading and language skills in children with poor reading

comprehension, Journal of Child Psychology and Psychiatry 51:9 (2010), pp 1031–1039

Catts. Hugh W, Adlof. Suzanne M, Weismer. Susan Ellis, Language Deficits in Poor Comprehenders: A

Case for the Simple View of Reading, Journal of Speech, Language, and Hearing Research Vol. 49 278–

293 April 2006

Catts. Hugh W, Fey. Marc E, Tomblin. J Bruce, Zhang. Xuyang, A longitudinal investigation of reading

outcomes in children with language impairments,

Journal of Speech, Language, and Hearing Research, Dec 2002, 45, 6

References



Hay. Ian, Gordon. Elias, Fielding-Barnsley. Ruth, Homel. Ross, Freiberg. Kate,

Language Delays, Reading Delays, and Learning Difficulties: Interactive Elements Requiring

Multidimensional Programming, Journal of Learning Disabilities, Sep/Oct 2007, 40, 5

Montgomery. James W., Magimaira. Beula M. j, Finney. Mianisha C., Working Memory and Specific

Language Impairment: An Update on the Relation and Perspectives on Assessment and Treatment,

American Journal of Speech-Language Pathology February 2010, Vol. 19 • 78–94 •

Rose, J 2006, Independent review of the teaching of early reading, Department for Education and Skills,,

www.teachernet.gov.uk/publications

National Reading Panel (NRP) 2000, Teaching children to read: An evidence-based assessment of the

scientific research literature on reading and its implications for reading instruction, US Government

printing Office, Washington, DC.

Joseph, LM & Schisler, R 2009, ‘Should adolescents go back to the basics?: A review of teaching word

reading skills to middle and high school students, Remedial and Special Education, vol.30, no. 3, pp131-

147.

Konza, D 2011, Research into practice: Understanding the reading process 1.3 Phonics,

www.decs.sa.gov.au/litercay/files/links/UtRP_1.2.pdf

Hattie, J 1999, Influences on student learning, Inaugural Lecture: Professor of Education, University of

Auckland.

Hempenstall, K 1999, Beginning Reading Instruction: The Role of Phonemic Awareness and Phonics, paper

presented to the Successful Learning Conference, University of Western Sydney, 23 July 1999.

Styslinger, M E 2012, 'Making meaning', Phi Delta Kappan, vol. 94, no. 4, pp40-48.

Norbury, C & Nation, K 2011, 'Understanding Variability in Reading Comprehension in Adolescents With

Autism Spectrum Disorders: Interactions With Language Status and Decoding Skill', Scientific Studies of

Reading, vol. 15, no. 3, pp191-210.

National Institute for Literacy (NIFL), 2010, The Research Building Blocks For Teaching Children to Read:

Put Reading First, 3rd edn, www.nifl.gov




http://www.teachernet.gov.uk/publications

http://www.decs.sa.gov.au/litercay/files/links/UtRP_1.2.pdf

http://www.nifl.gov/

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