screening for dyslexia, dyspraxia and visual stress in he s.a. nichols, j.s. mcleod, j.m. brown,...

Screening for dyslexia, dyspraxia and visual stress in

HE

S.A. Nichols, J.S. McLeod, J.M. Brown, L.J. Smith, F. Summerfield, R.L. Holder *

Centre for Inclusive Learning Support,

University of Worcester* University of Birmingham

Original AimsTo analyse the effectiveness of current screening practice at UW and compare it with a computerised method, LADS (Lucid Adult Screening Test):

Tutor method consists of selected subtests from:

Bangor Dyslexia Test (BDTA) (Miles 1983); and

Dyslexia Adult Screening Test (DASTA) (Fawcett and Nicolson 1998)

Definitions

• Dyslexia “is evident when accurate or fluent word reading and/or spelling develops very incompletely or with great difficulty’ (Singleton, 1999, p.18)

• Dyspraxia is regarded as an impairment or immaturity of the organisation of movement. Associated with this may be problems of language, perception and thought (Dyspraxia Foundation, 2007)

Definitions

• Visual stress is not currently defined as a specific learning difficulty. In identifying stress we follow the definition by Kriss and Evans (2005, p.1) of a syndrome characterised by ‘symptoms of visual stress and visual perception disorders that are alleviated by using individually prescribed colour filters.’

The screening and assessment process

Self Referral Screening

+ve =Assessment Debrief

DSA applied

for

Needs Assessment

121 support starts

-ve = suggest other help

Model

• As screeners we are looking for signs of the same difficulties used by assessors to identify SpLD.

• We do not spend much time exploring the student’s history of difficulty, nor do we look at differentials between underlying ability and achievement. So we are looking for problems in the following:

Difficulties investigated

• Working memory• Phonological processing• Visual processing• Sequencing and orientation• Hand-eye coordination• Spelling• Reading• Writing

Plus possible genetic factors

Recruitment Process

100 participants are recruited from UW students

99 participants complete

computer and tutor screenings

and 2 questionnaires

1 participant withdraws before completing both

screenings

347 ITE students are given details of

project by project team during lectures

and are invited to volunteer

3 volunteer from other

subject disciplines

and are not

recruited

Screening results99 participants

complete computer and

tutor screenings

31 participants screened

positive by tutor only

All 71 invited to

assessment

28 participants screened

negative by both

screenings

30 participants screened

positive by both

screenings

10 participants screened

positive by computer

only

Project process

7 participants

withdraw before being

assessed

7 were previously

assessed for dyslexia: 3 were re-

assessed

4 participants are still to be

assessed

56 assessments

were completed

4 earlier assessments were included

60 assessments

used in analysis

All 71 invited to

assessment

Dyspraxia

Visual Stress

Dyslexia

21

1

45

8

5 1

Assessed negative = 15

Co-morbidity of dyslexia, dyspraxia and visual stress from the 60 assessments used.

Additional Aims

• How well does our tutor screening tool identify SpLD?

• Can the tool, or the process with which it is used, be improved?

Analysis

To assess the accuracy of our battery for identifying SpLDs, we:

• calculated sensitivity and specificity for various combinations of subtests

• calculated the statistical significance of correlations between each subtest and each condition

• used logistic stepwise regression analysis to determine the most effective combination of tests

7277

92

6978

82

65

86

010

203040

50607080

90100

BDTA DASTA Tutor LADS

Pe

rce

nt

sensitivity specificity

Dyslexia

67

78

94

72

61 64

49

70

0102030405060708090

100

BDTA DASTA Tutor LADS

Per

cent

sensitivity specificity

Dyspraxia

71

88100

6562 66

49

68

0

20

40

60

80

100

BDTA DASTA Tutor LADS

Pe

rce

nt

sensitivity specificity

Visual Stress

6976

93

64

8188

74

88

0

20

40

60

80

100

BDTA DASTA Tutor LADS

Pe

rce

nt

sensitivity specificity

Any SpLD

  BDTA

left-right

polysylla

ble

s

subtra

ction

tables

mo

nths fw

d

mo

nths rvsd

b/d

con

fusion

familial

inciden

ce

Dyslexia               

Dyspraxia               

Visual Stress                

Any SpLD               

  p <0.01

  p <0.05

DASTA

one

min

ute

read

ing

pho

ne

mic seg

.

two

min

ute

spellin

g

non

sense

one

min

writing

dig

it span

rapid

nam

ing

Dyslexia             

Dyspraxia             

Visual Stress             

Any SpLD             

  p <0.01

  p <0.05

Sum of stepwise regression analyses

• Left/right confusions• Polysyllables• Subtraction• b/d confusions• One minute reading• Phonemic segmentation• Digit span• Nonsense reading• One minute writing

What next?

• A shortened battery of screening tests plus test for visual stress

• A computerised pre-screening test

• An analysis of barriers to referral

• Further promotion of the Disability and Dyslexia Service.

One minute reading for a student aged 22 -24 years

• 97 – 126 words = no risk

• 86 – 96 words = low risk

• 71 – 85 words = moderate risk

• 70 or less words = high risk

One minute writing for a student aged 22 – 24 years

• 32 -39 words = no risk

• 30 -31 = low risk

• 21 -29 = moderate risk

• 20 or less = high risk

Questions?