Understanding Specific Learning Difficulties: Identification and Diagnosis

(Briefing)

Helen Duncan (Disability Adviser (SpLD))

Disability Resource Centre

Aims

This session aims to promote an understanding of:

•The SpLD assessment process and model

•How an SpLD diagnosis is obtained

•The time frame for the SpLD diagnostic process

Aims: to address common concerns

Commonly asked questions:

•Why are students assessed for the first time at University?

•How robust is the assessment process?

Assessment process

What is Dyslexia?

• Definition (handout)

• Problems in:

• Speed of processing (visual and phonological)

• Working memory

• Phonological awareness

• Deficit model / discrepancy model

• Subtle profiles – relative /absolute difficulties

Profile of dyslexia ‘spiky profile’

 

Case study – Jane e-mails DRC

Student receives e-mail from SpLD administrator with following:

• Appointment date (up to 2 weeks) & Confidentiality agreement (disclosure)

• Pre-screening questionnaire (self-completion)

• Closed questions and narrative responses

• Students own description of difficulties/concerns

• Referral for eye test

• Eliminate eye conditions as reasons for literacy problems

• Request for sample of unedited handwritten notes (lecture notes / supervision essay)

Jane – pre-screening questionnaire

What do her responses indicate at this stage?

• Working memory (times tables / sequencing ideas)

• Phonological awareness (poor at listening aspect of French, difficulty with new words)

• Speed of processing (slow reading, slow writing of ideas)

Refer to definition of dyslexia

Familial history of SpLD (brother, father)

Screening interview - purpose

• 1:1 with SpLD specialist

• Structured interview

• Questions are trigger points

• Looking for patterns consistent with SpLD (or other)

• Eliminate other reasons for the difficulties

• Norm referenced tests

• To support/contradict interview findings

1.5 hour screening interview – structured questions

Medical Background

•Eliminating other causes for difficulties :• depression, epilepsy, ME, Anorexia, medications, etc.

can affect working memory & speed of processing. • Eye conditions and hearing loss can affect literacy skills

•Noting any medical conditions that are positive indicators of SpLD (allergies, recurrent ear infections as child, premature birth)

Screening interview – educational background

• Identify that signs of SpLD were present throughout schooling (albeit not diagnosed)

• Difficulties in specific areas relating to dyslexia (i.e. not general problems)

• Learning additional languages• Essay writing (structure/organisation)• Lack of automaticity of literacy skills• Discrepancies across subjects

• Eliminate other causes for difficulties (changes of school/ unconventional schooling, additional languages)

Screening interview – structured questions

• Language/listening behaviour

• Writing and spelling

• Reading

• Note-taking

• Maths

• Memory

• Spatial/temporal

• Visual motor

Screening interview – data

• Adequate cluster of signs of deficits in:

• working memory

• Processing speed

• Phonological awareness

• Select norm referenced tests to test findings:

• Speed of reading (TOWRE form A – SS=89)

• Spelling- (WRAT –IV blue - SS= 105)

• Rapid naming (objects and colours) (CTOPP – SS= 85)

Screening interview – Jane’s outcome

• Test results lower than expected

• Test results consistent with reported problems in processing speed and spelling

• Outcome warrants referral for full diagnostic assessment to EP

• Write up outcome of screening interview as short report and pass this to diagnostic assessor (see handout).

Full Diagnostic assessment

• Appointment with EP – around 2 weeks from referral by DRC (longer if student needs to obtain funding from ALF)

• DRC pool of EP’s are quality assured by DRC & liaise closely with DRC Disability Advisers

• Student may need to travel to London

• Session lasts around 4 hours & Costs £400

Full Diagnostic assessment - Jane

•Verbal comprehension (verbal IQ -WAIS-IV – 4 subtests) –SS=151

•Perceptual organisation (nonverbal IQ – WAIS-IV – 4 subtests)- SS=150

•Processing speed ( visual processing -WAIS-IV – 2 subtests) SS=89

•Working memory( auditory memory - WAIS-IV – 2 subtests) SS= 96

Full Diagnostic assessment - Jane

• Phonological processing

• Phonological awareness (2 x CTOPP subtests) SS=90

• Phonological memory (2 x CTOPP subtests) SS=95

• Speed of processing phonological information from long term memory (rapid naming) (2 x CTOPP subtests) SS=90

• Supplementary CTOPP subtests available if needed

Full Diagnostic assessment - Jane

• Single word reading (untimed) (WIAT-II – SS 110)

• Single word reading (timed) (TOWRE – SS 90)

• Non-word reading (timed) (TOWRE– SS 88)

• Reading comprehension ((ART)

• Reading Accuracy – SS= 92

• Comprehension –SS=110

• Speed of Reading (rate) – SS=84

• Writing Speed (wpm) - 19 wpm (average undergraduate = 24 – 28wpm) (5 min precise task)

Full Diagnostic assessment - Writing/Spelling

• Single word spelling – SS= 101

• Timed prose writing (20 minutes)

• Spelling when writing in prose

• Use of expressive vocabulary

• Organisation of ideas

• Sentence structure/ grammar & punctuation

• Legibility and speed of handwriting (17 wpm)

Full Diagnostic assessment - outcome

EP Compares:

1. data across all the psychometric tests & test behaviour

2. outcome of screening interview

3. students self report of difficulties

Full Diagnostic assessment - outcome

Diagnosis of dyslexia due to all consistently showing similar degree of deficit in:

• Working memory

• Speed of processing

• Phonological awareness

•Therefore, meets definition of dyslexia (see definition on handout)

•Recommendation is 25% extra time in exams to compensate for slow processing speed (slow reading and writing) and poor working memory (need to re-read)

Diagnostic assessment process - timeframe

• Student contact – screening interview appointment = 2 weeks

• Screening interview appointment – EP appointment = 2 weeks

• EP write up report = 2 weeks

• Student feedback appointment at DRC for support arrangements = 2 weeks

• Minimum of 8 weeks from initial contact to discussion of report and support arrangement

• In addition – during feedback meeting student applies for DSA to fund support– 12 weeks process before funding for support is available.

Diagnostic assessment process

Any questions?

Diagnostic assessment process

Useful contacts and links:

•DRC website

•Inclusive teaching DRC Online resources (via DRC website)

•DRC workshops : Teaching students with Specific Learning Difficulties (via PPD)