“adult persons with dyslexia. university and work place. same problems? different...
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“Adult persons with Dyslexia. University and work place. Same problems? Different possibilities?”. Enrico Ghidoni, MD Associazione Italiana Dislessia [email protected]. Adult dyslexics in Italy. Estimated prevalence of Dyslexia in Italy is 3 %. - PowerPoint PPT PresentationTRANSCRIPT
“Adult persons with Dyslexia. University and work place. Same
problems? Different possibilities?”
Enrico Ghidoni, MDAssociazione Italiana Dislessia
Adult dyslexics in Italy
• Estimated prevalence of Dyslexia in Italy is 3 %.
• But in 2 out of 3 cases Dyslexia isn’t recognized at school.
• So there are a lot of unrecognized adult dyslexics (in universities, at work, in social life…).
• Dyslexia may be compensated but the neurobiological substrate is still present.
Questions about adult dyslexia 1
• What are the cognitive and psychological characteristics of adult dyslexics?
• Is the adult dyslexia profile different from that in the developmental age?
• What are the parameters for diagnosis (reading time, speed, accuracy…)?
• How many parameters must be abnormal to diagnose dyslexia?
• What tools to measure these parameters?
Questions about adult dyslexia 2
• Can Compensation make the disorder undetectable using any tool?
• How can we define diagnostic subcategories such as mild, moderate and severe dyslexia or phonological, superficial dyslexia……
• What are the residual patterns of each SLD?
Questions about adult dyslexia 3
• Are there adult dysfunctional patterns due to SLD which are unclassifiable according to common categories?
• Is there a specific history pattern for every SLD?• What kind of aid and support for adult SLD?• What compensatory tools are really effective?• To what extent is research on English-speaking
dyslexics transferable to our context?
Questions about adult dyslexia 4
• What is the natural history of dyslexia?• Is there any advantage for those who have
received a diagnosis and support?• Are there predictive factors for the evolution
of dyslexia in adult age?
Adult dyslexics – the facts
• Persistent phonological dysfunction
• Variable effect on life activities (study and work)
• Psychological fall-out
• Personal coping
D. Pollak: Four types of dyslexic student:
•The ‘patient’•The ‘student’•The ‘hemispherist’•The ‘campaigner’
Pollak• Those I called ‘patients’ had internalised a medical
view of dyslexia; they saw themselves as suffering from a condition which made them defective.
• The next group, I called ‘students’; they focused on the discrepancy between their IQ and their scholastic attainments, and regarded dyslexia as something which affected them only in an educational context.
• The ‘hemispherist’ group were good at metacognition, i.e. analysing the ways in which they learned; they were aware of their own strengths, for example in visualisation and holistic thinking.
• The fourth group, I called ‘campaigners’; they viewed dyslexia as a political issue, and were determined to fight for their right to be taught and assessed in dyslexia-friendly ways.
McLoughlin et al’s four types of dyslexic adult:
• unaware that they are dyslexic, and thus have no strategies for success
• aware that they are dyslexic, but still have no strategies
• aware that they are dyslexic, and have unconscious strategies
• aware that they are dyslexic, and make conscious use of good strategies.
Critical issues for adult diagnosis in Italy
• Adults (>18 ) are not treated by health services for childhood and adolescence
• There are hardly any standardized tests for subjects over 18.
• There is little interest in neuropsychology laboratories for adult neurological diseases
• The examination batteries for adult acquired dyslexia were conceived to evaluate disorders which are very different from developmental dyslexia.
Diagnostic demand
• University and College students who want to take advantage of accommodations now available in many universities;
• Students who have to take exams (state exams, public selections, driving license);
• Adults who wish to go back to school to obtain secondary school qualifications;
• Parents of DYS children who want to understand their own difficulties
Screening in adults
• Adult Dyslexia Check List, Vinegrad (ADCL) 1994
• Adult Reading History Questionnaire, Lefly & Pennington, 2000
• Lucid Adult Dyslexia Screener (LADS) Singleton, 2002
• On-line Questionnaires, Kasler e Fawcett, 2009
Project Adult Dyslexia Diagnosis
• Associazione Italiana Dislessia
• University of Modena and Reggio E.
• Arcispedale S. Maria Nuova, U.O. Neurology Unit, Neuropsychology Lab
Standardization study regarding controls
Identification of sensitive tests
(controls/dyslexics comparison)
Clinical study on adults, students or other
Project phases1
2
3
1. Standardization study
• Control group: N = 80 (AVIS volunteers, students, hospital staff)
• Mean values and standard deviation (percentiles for error scores)
• Four age groups: 18-24; 25-34; 35-44; 45-54
• Cut-off: - 2 standard deviations;
• 95° percentile for error scores
Test sensitivity (% positive results )
• Word lists: time 52%
• errors 40%
• speed 31%
• Non words time 69%
• errors 37%
• speed 52%
• Non word writing 29%
• ADCL 93%
• Text Reading:
• time 56%
• errors 38%
• speed 48%
• Allographs time40%
Test sensitivity (% positive results )
• N&D 1 time 29%• N&D 2 time 21%• N&D 2 time 23%• N&D 3 time 33%• N&D 3 errors 40%• Backward counting:• time 27%• errors 44%
• RAN:• Digits time 31%• Letters time 29%• Colours time 35%
• Word Span 13%• Visual search matrices
27%
3. Clinical study: Examination procedure
• Clinical interview
• Family history
• Personal history (medical and educational)
• Neuropsychological history (previous and current trouble)
• Preliminary tests (ADCL, Raven PM38, Oldfield, Beck DI, Hamilton Anxiety)
• Text, word list, non word reading
• Allograph Comparison
• Text comprehension
• Non word writing
• RAN (digits, letters, colours)
• Night & Day attention test
• Counting backwards
DD Adult Basic Battery
Additional Investigation
• Questionnaire /partially structured interview about self narrative
• Central Auditory Processing Disorder Checklist
• Psychological tools to evaluate affective relational aspects (BDI, Hamilton )
Single case in depth study
• Calculation (dyscalculia battery)
• Short term memory(digit span, Corsi’s cubes, word span; dual task)
• Long term Memory (verbal, visuo-spatial…)
• Language (fluency, naming, metaphors comprehension , verbal judgements, etc)
• Writing (Luzzatti test)
• Attention (Visual Matrices, Stroop, Trail making)
• Intelligence (WAIS-R)
• Visuo-spatial functions (Benton line orientation, Rey’s figure)
University Students (N 37)
• Primary Education 7• Engineering 5• Architecture 3• Economics 3• Communications 3• Law 3• Arts 3• Medicine; Veterinary 3• Psychology 3• Sociology 2• Nursing studies; Physical Education 2
Dyslexia at University
• An increasing number of DYS students
• Dynamics of Relationship with peers, teachers, administration
• Support measures and tools
• Tutoring, Negotiation, Mediation
In Italy :estimated prevalence amongst university students 1%
(Singleton, 2009)
Results in our sample
• Dyslexics are present in all degree courses.
• There is a high rate of “new” diagnoses (over 60% of cases)
• Academic and psychological problems are more evident if dyslexia is associated with dyscalculia
In the workplace
• Compensations and strategies
• A misunderstood style of work
• “I need more time!”
• Silly mistakes and managerial ability
• Negative stigmatization
• Choosing an occupation
• Disclosure and acceptance
The world of adult dyslexics
• A wide variety of ways of experiencing and understanding one’s own dyslexia (Fulgeri, 2010; Cardano, 2010)
• Discovery or creation of the niche
• Finding the right social and professional niche improves functional and psychological compensation
Personal experience
• Self narratives as a tool for reconstructing one‘s own identity
• To what extent is identity building conditioned by dyslexia?
• Diagnosis may be a turning point in life, a biographical transition.
Dyslexic identities
The social reality of dyslexia
• Cultural evolution
• Awareness of neurobiological ontology
• Protection and support require the recognition of the difference (labelling)
• Anti-label positions
• Labelling and stigma: which comes first?
• Ideology and stereotypes
Reggio Emilia, Italy