Reading Difficulty in Children

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Reading Difficultyin Children
Dr. Steve Dawson Clinical Psychologist Southern
Community Welfare Caring, Equipping, Empowering,
Hope 2-4 Tea Gardens Avenue KIRRAWEE NSW
2232 (02) 9545 0299 www.scw.org.au
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Reading Difficulty/Dyslexia

• 4 main learning disorders according to DSM-IV
• Reading disorder (i.e., dyslexia).
• Writing disorder (i.e., dysgraphia).
• Mathematical disorder (i.e., dyscalculia).
• Mixed learning Disorder-NOS
• Dyslexia (Derived from Greek Dys means poor and
  Lexis means language) Reading achievement, as
  measured by individually administered tests of
  reading accuracy and comprehension, is
  substantially below that expected given the
  persons chronological age, measured
  intelligence, and age-appropriate education.

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Dyslexia (2000) Dyslexia is
one of several distinct learning disabilities.
It is a specific language-based disorder
characterized by difficulties in the development
of accurate and fluent single word decoding
skills, usually associated with insufficient
phonological processing abilities.
International Dyslexia Society (Lyon, 1995
Shaywitz, 1996),
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Early Warning Signs

• Delay in speaking
• Mispronouncing
• Misnaming
• Insensitivity to rhyme
• Talks around a word
• Word retrieval probs

• Understands meaning of words
• Difficulty with segmenting, blending, and rapid
  naming
• Difficulty knowing letter names, sounds

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Theoretical Background

• Two main reading processes
• Phonology (i.e., auditory perception)
• Orthography (i.e., visual perception)
• Two main perspectives
• Phonological core
• Double-Deficit hypothesis
• Strong evidence for importance of phonology in
  dyslexia, though orthography also important e.g.
  Prof Kristen Pammer, ANU
• Supported by recent neuroimaging studies

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The Reading System(Prof Max Coltheart, Macquarie
Univ)
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Dyslexia Disruption in Posterior Brain Regions
Neural systems for reading that are disrupted in
dyslexic children.
Shaywitz et al. (2002) Biol. Psychiat., 52,
101-110.
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Magneto-encephalography (MEG) scanner

• Macquarie University awarded ARC Linkage
  Industrial Partners Grant for 2006-2009 (total
  970,000).
• World's first MEG (magnetoencephalography) brain
  imaging system specifically designed to study
  cognitive processing in children
• Safe, painless, non-invasive
• Detects small bio-
• magnetic brain signals
• Provides real-time information about which brain
  areas are active and when during task performance

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Dorsal (Where) and Ventral (What) Visual
Streams in Human (PET)
Dorsal (where) pathway shown in green and blue
and Ventral (what) pathway shown in yellow and
red serve different functions. (Leslie
Ungerleider).
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• Prerequisites of beginning reading
• General language skills
• Exposure to print at home
• Parents educational level
• Early letter recognition skills

• phonological awareness
• an ability to segment speech input into small
  non-meaningful units (particularly phonemes)
• what is left if you take the l sound away from
  lame?
• what do you get when you add the k sound to
  are?
• After understanding that speech can be segmented
  to phonemes, a relatively small step is needed to
  crack the written code.

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• Important Research Findings
• Dyslexia occurs primarily at the level of the
  single word and involves the ability to read and
  spell printed words. This has been known for
  many years. It has not been clear why.
• Single word reading problems are primarily
  associated with problems segmenting words and
  syllables into phonemes. This is true in
  virtually all poor readers, including children,
  adolescents, and adults--at all levels of IQ--and
  in socially disadvantaged children and adults.

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3. Reading is dependent on language, but

• It is not a natural outgrowth of language. It is
  scaffolded on oral language.
• Language, which humans have possessed for many
  thousands of years, usually unfolds as a natural
  biological progression--reading, which humans
  have had for only about 4,000 years, is not a
  natural biological unfolding.
• Reading is based on language, but must be taught.

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4. Dyslexia is Dimensional

• Dyslexia occurs along a continuum that blends
  imperceptibly with normal reading ability a
  lower portion of a continuum of reading
  capabilities (Shaywitz et al., 1992, p. 148).

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5. Children Do NOT Outgrow Dyslexia

• Over 70 identified as dyslexic in Grade 3
  remained dyslexic as adults
• Without adequate intervention, dyslexia can be a
  lifelong, chronic disorder
• Connecticut Longitudinal Project- Shaywitz et
  al., Pediatrics, 1999

6. Causes of Dyslexia Poor Reading

• Neurobiological
• Familial
• Economic disadvantage cultural and linguistic
  diversity
• Instructional

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Neuroimaging Research and Dyslexia Brain
metabolism when doing reading tasks involving
word reading is different in dyslexic and
non-dyslexic readers. The problem is not brain
structure, but brain function.
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Dyslexia Assessment
? Intelligence tests ? Phonological Awareness ?
Rapid Naming ? Verbal Memory Tests ? Reading
Fluency ? Visual/Spatial Skills ? Executive
Functioning ? Family History
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INTELLIGENCE TESTS
?Evaluate WISC IV or other cognitive measures in
terms of level of performance AS WELL AS pattern
of performance DOMAIN PATTERNS ? Lower Verbal
IQ Phonological Dyslexia ? Lower Perf IQ
Surface Dyslexia ? Lower WMI Comprehension
Issues ? Lower PSI Related to all of the above
as well as math and written language disorders.
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INTELLIGENCE TESTS
WISC IV SUBTEST PATTERNS ? Vocabulary
Similarities sophistication of language usage
skills. Poor scores associated with limited
word retrieval skills, and perhaps phonological
dyslexia. ? Block Design - detail errors reflect
poor visual pattern recognition skills (Surface
Dyslexia). Pattern errors reflect poor executive
functioning skills.
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INTELLIGENCE TESTS
WISC IV SUBTEST PATTERNS ? Letter Number Digit
Span - poor scores reflect limited working memory
. This may hinder phonological memory as well as
reading comprehension. ? Symbol Search and
Coding - lower scores indicative of slower
processing speed and may lead to diminished
reading speed and fluency.
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PHONOLOGICAL AWARENESS

• Wechsler Individual Achievement Test Second
  Edition (WIAT-II) Pseudoword Decoding subtest
• ? Neuropsychological Assessment for Children
  Second Edition (NEPSY-II) Phonological
  Processing subtest

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PHONOLOGICAL AWARENESS
WIAT-II Pseudoword Decoding fum snay gritch lirst
pragment cind
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PHONOLOGICAL AWARENESS
NEPSY Phonological Processing 1. Say remember
but do no say re 2. Say coat but do not say
/k/ 3. Say captivate but do not say ate 4. Say
shake substituting st for sh 5. Say pack
substituting n for k
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Key Elements of Effective Early Intervention

• Systematic and direct instruction in
• Phonemic awareness
• Explicit Phonics
• Practice in applying skills to reading/writing
• Fluency training
• Enriched language experiences

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Teaching SLD Students to Read

• use state-of-the-art evidence based
  instructional strategies and commercial reading
  programs e.g. Jolly Phonics, THRASS (Teaching
  Handwriting, Reading and Spelling Skills),
  Spalding Method.
• For more information see numerous reading
  programs reviewed in chapters 15 19 of
  Overcoming Dyslexia (Sally Shaywitz).

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Oral Reading

• Once a student is fairly fluent and has received
  adult feedback, use Guided Repeated Oral Reading.
• To build up the numerous repetitions needed, use