Title: Guidance on Implementation
1 Guidance on Implementation For the
Identification of Students Suspected of Having
a Specific Learning Disability
Developed by the Maine Association of School
Psychology September 2008
2- Welcome
- Assumptions
- Compliance with Me Regs
- Professional respect
- Commitment to service for children with special
needs - Special Education service for students with
disabilities - Conceptual understanding of the Federal intent
for determining eligibility
3 - Housekeeping tasks
- Schedule for today
- Plan for working through the document
- How to handle questions
- Afternoon Session
- Parking Lot
- Case studies
4HISTORICAL ROOTS
- Discrepancy Model IDEA 2004
- Task Force Maine 101
- SLD Form MASP Clinical
Guidance
5SLD Discrepancy Model
- Many Problems
- Clinically Inaccurate
- Lengthy Identification Process Wait to Fail
- Educationally Ineffective Not closing gap
- between disabled and non-disabled students
6IDEA 2004 - SLD Identification
- Definition unchanged A disorder in one or more
of the basic psychological processes - Procedural Changes in SLD Identification
-
- 1. No longer require old discrepancy model
- 2. Introduction of RTI as an alternative
- 3. Vague alternative - hybrid discrepancy model
7Maine 101
- Task Force on Eligibility Stakeholders
- Specific criteria for processing disorders
- Limit which processing disorders - 2
- Define severity 1.5 SD lt Mean
- Require research based correlation - .001
8RTI
- Supported by Task Force, MASP NASP
- Nearly undermined in Chapter 101
- Note SAUs may use the discrepancy model
- 3 Year Phase In
9SLD Form MASP Guidance
- New SLD Identification form developed by MADSEC
- Legal Consultation
- Adopted by DOE
- DOE agreed to MASP request to develop Guidance on
Implementation - MASP develops clinical guidance to improve
understanding and increase consistency - Presentation to MADSEC Oct. 27th
10- .from Chapter 101
- A student with a specific learning disability
exhibits a disorder in one or more of the basic
psychological processes involved in understanding
or in using language, spoken or written, that may
manifest itself in an imperfect ability to
listen, think, speak, read, write, spell, or to
do mathematical calculations,
11- Including conditions such as perceptual
disabilities, brain injury, minimal brain
dysfunction, dyslexia, and developmental aphasia.
12Cognitive Processes
- Item 1 LD document (handout, page 3) A
disorder in one or more of the basic
psychological processes - What are psychological processes?
- How many are there?
- Which ones are important?
- Why do we care?
- Introductions to Appendices I and II
-
13- Theoretical Models
- Require a thoughtful approach to evaluation
- Important for driving local process/procedures
- Choose instruments that match your theoretical
model - Two widely used/researched/recognized models
- Not exclusive
- Appendix (I, page 11)
- School Neuropsychology
- Cattell-Horn-Carroll
- No definitive list (Appendix II, page 16)
14CHC Theory
- Based on the belief that intelligence is
described structurally - Recent theories have converged on a more complete
multiple-cognitive abilities taxonomy - Cattell-Horn Fluid/Crystallized theory (1960s)
- Carroll Three-Stratum Theory of Cognitive
Abilities (general intelligence, broad factors,
narrow factors) (1990s)
15- Recent factor analyses indicate that most current
intelligence tests do not adequately assess the
complete range of broad cognitive abilities - Contemporary theory and research necessitates a
more complete sampling of skills and abilities
16Cross Battery Approaches
- Allow for a more valid and comprehensive
assessment - XBA approach is
- Time efficient
- Grounded in CHD theory and research
- Reliable measure of wider or deeper range of
cognitive abilities/processes
17- Circumvent significant weaknesses in
intracognitive discrepancy models (LD diagnosis) - VC-PR split
- Score variability
- Richard Kaufman (2000)
- Based on sound assessment principles
- Adds theory to psychometrics
- Improves quality of assessment and interpretation
18Theoretical Framework
- Complete taxonomic framework for describing
structure and nature of intelligence - CHC broad classifications of cognitive ability
tests - CHC narrow classifications of cognitive ability
tests - Coursework is available
19Broad Abilities
- Fluid Intelligence (Gf)
- Crystallized Intelligence (Gc)
- Visual Processing (Gv)
- Short-Term Memory (Gsm)
- Auditory Processing (Ga)
- Long-Term Retrieval (Glr)
- Processing Speed (Gs)
20Fluid Intelligence (Gf)
- The ability to reason and solve problems that
often involve unfamiliar information or
procedures. Manifested in the reorganization,
transformation, and extrapolation of information.
21- Non-Verbal Fluid Reasoning SB 5
- Matrix Reasoning WECH
- Concept Formation WJ III
- Analogic Reasoning UNIT
- Analysis/Synthesis WJ III
- Cube Design UNIT
- Picture Concepts WISC-IV
- Number Series WJ III DS
22Crystallized Intelligence (Gc)
- The breadth and depth of knowledge including
verbal communication and information. Reasoning,
when using previously learned procedures, is also
included.
23- Similarities WECH
- Comprehension WECH
- Verbal Knowledge SB 5
- Vocabulary WECH
- Verbal Knowledge KABC-II
- Verbal Comprehension WJ III
- Nonverbal Knowledge SB 5
24- Information WECH
- General Information WJ III
- Comp of Instructions NEPSY
25Auditory Processing (Ga)
- The ability to discriminate, analyze, and
synthesize auditory stimuli. Also, related to
phonological awareness.
26- Incomplete Words WJIII
- Sound Blending WJIII
- Auditory Attention WJIII
- Sound Patterns WJIII
- Elision CTOPP
- Segmenting Words CTOPP
- Sound Matching CTOPP
- Phonological Processing NEPSY
27VIsual Processing (Gv)
- Spatial orientation, the ability to analyze and
synthesize visual stimuli, and the ability to
hold and manipulate mental images.
28- Block Design WECH
- Verbal Visual-Spatial Proc. SB 5
- Spatial Relations WJ III
- Planning WJ III
- Picture Completion WECH
- Route Finding NEPSY
- Design Memory WRAML 2
- Picture memory WRAML 2
29- Picture Recognition WJ III
- Object Memory UNIT
- Spatial Memory UNIT
- Symbolic Memory UNIT
- Visual Closure WJ III DS
- Mazes UNIT
30Long-Term Retrieval (Glr)
- The ability to store information efficiently and
retrieve it later through association.
31- Memory for Names NEPSY
- Visual Auditory Learn WJ III
- Delayed Recall, Names WJ III DS
- Del Recall, Visual-Auditory WJ III
- Retrieval Fluency WJ III
- Picture Naming Speed WJ III
- RAN CTOPP
- Speeded Naming NEPSY
32Short-Term Memory (Gsm)
- The ability to hold information in immediate
awareness and then use it within a few seconds,
also related to working memory.
33- Memory span
- Verbal Working Memory SB 5
- Memory for Words WJ III
- Digit Span WECH
- Number-Letter WRAML2
- Phonological Memory CTOPP
34- Working memory
- Letter-Number Seq. WECH
- Numbers Reversed WJ III
- Phonological Memory CTOPP
- Symbolic Working Memory WRAML2
- Verbal Working Memory WRAML2
35Processing Speed (Gs)
- Speed and efficiency in performing automatic or
very simple cognitive tasks.
36- Symbol Search WECH
- Coding WECH
- Decision Speed WJ III
- Visual Matching WJ III
- Pair Cancellation WJ III
37School Neuropsychology Model
38Evolution of School Neuropsychology
- 1960s First child neuropsychological test
battery - 1980s First School Neuropsychology
publications - 1990s NICHHD Federally funded SLD and
Attention Research Decade of the Brain - 1999 American Board of School Neuropsychology
39American Board of School Neuropsychology
- Developed a conceptual model
- Teaches a year long course
- Diplomat Procedure
- 2006 First National School Psychology
Conference - Publications
- Essentials of School Neuropsychology
- Neuropsychology of Reading, Writing Math
- Handbook of School Neuropsychology, etc
40Definition
- Requires the integration of
- neuropsychological and educational
- principals to the assessment and
- intervention processesto facilitate
- learning and behavior within the
- school and family systems
41School Neuropsychological Conceptual Model
42Sensory-Motor Functions
43Sensory-Motor
- Processing of incoming sensory input and the
coordination of motor output - Primary Areas of Sensory Lobes
- Frontal Lobes - Motor Strip
- Sensory-motor functions serve as building blocks
for higher order neurocognitive processes
44Sensory-Motor
- Motor Skills
- Gross Motor
- Fine Motor
- Sensory Functions
- Visual
- Auditory
- Tactile
- Vestibular
- Olfactory
- Sensory-Motor Integration
45Sensory-Motor Tests
- Dean Woodcock Sensory Motor Battery
- Bender Gestalt
- NEPSY-2 Design Copy, Fingertip Tapping,
- Imitating Hand Positions,
Manual - Motor Sequences,
Visuomotor Prec - OT Tests Bruininks-Osteretsky Test of Motor
- Proficiency
- Movement Assess. Batt. for
Children - Peabody Developmental Motor
Scales
46Attentional Processes
47Attentional Processes
- Serve as baseline for higher order processes
- Subcortical Reticular Activating System
- Regulates Arousal
- Frontal Lobes Limbic System Higher level
- attentional
processing - Cognitive Attentional Processes
- Behavioral Manifestations of ADHD
48Attention
- Focused/Selective Attention
- Shifting Attention
- Sustained Attention
- Divided Attention
- Attentional Capacity
49Assessment of Attention
- NEPSY-II
- Auditory Attention Response Set
- TEA-Ch
- D-KEFS
- Color-Word Interference
- Trail Making
- Design Fluency
- Verbal Fluency
- WRAML-2
- Finger Windows
- Number/Letter
-
50Visual-Spatial Processes
51Visuo-Spatial
- Processing visual input and locating it in space
- Occipital Parietal Lobes
52Visual-Spatial
- Visual Discrimination
- Visual Attention
- Visual Scanning/Tracking
- Visual Sequencing
- Visual Organization
- Visual Working Memory
- Orthographic Processing
- Perceptual Reasoning
53Visual Spatial Tests
- WISC-IV Perceptual Reasoning Subtests
- Symbol Search
- NEPSY-II Arrows, Block Construction, Design
- Copy, Geometric Picture
Puzzles - PAL-II Orthographic Processing Subtests
- Test of Visual Perceptual Skills
- Developmental Test of Visual Perception
- Rey Complex Figure Test
54Language Functions
55Language
- Auditory/Phonological Processing
Temporal-Parietal Lobes - Receptive Language Temporal Lobes
- Expressive Language Frontal (Brocas Area)
56Language Functions
- Auditory/Phonological Processing
- Auditory Discrimination
- Auditory Attention
- Auditory Sequencing
- Auditory Working Memory
- Receptive Language
- Listening Comprehension
- Receptive Vocabulary
57Language Functions
- Oral Expression
- Articulation
- Verbal Fluency
- Language Based Reasoning
- Expressive Vocabulary
- Grammar
58Language Testing
- WISC-IV Verbal Comprehension Subtests
- PAL-2 Phonological Processing Subtests
- Morphology Syntax Subtests
- WJ-III Sound Blending, Incomplete Words,
- Verbal Comprehension, Picture
Vocab - NEPSY-II Comp. of Instructions, Phonological
- Processing, Speeded Naming
- CELF
- CTOPP
59Memory and Learning
60Memory
- Ability to acquire new information,
- Store the information
- Retrieve the information
- Hippocampus
- Sensory Lobes
- Frontal Circuits
61Memory Learning
- Verbal Immediate Memory
- Visual Immediate Memory
- Verbal-Visual Associative Memory
- Visual Long Term Memory
- Verbal Long Term Memory
- Working Memory
- Semantic Memory
- (Encoding, Storage, Retrieval, Procedural)
62Memory Learning Tests
- WISC-IV Working memory subtests,
- vocabulary, information
- NEPSY-II List Memory, Mem for Designs,
- Mem for Faces, Mem for
Names - PAL-II Working Memory Subtests,
- Orthographic Processing
Subtests - WRAML-II
- TOMAL-II
63Executive Functioning
64Executive Functions
- Functions required for engaging in systematic
problem solving behavior
65Executive Functions
- Frontal Lobes
- Dorsolateral Prefrontal Cortex Dr. Spock
- Orbitofrontal Cortex Emotion - Impulsivity
- Anterior Cingulate Motivation apathy/OCD
- Skeletomotor Circuit Gross Fine Motor
- Oculomotor Circuit Eye Movement
- Temporal/Parietal Working Memory
-
66Executive Functions
- Concept Generation
- Inhibition
- Motor Programming
- Set Shifting
- Planning, Fluid Reasoning Problem Solving
- Retrieval Fluency
- Working Memory
67Executive Functioning Tests
- WISC-IV Perceptual Reasoning Subtests,
- Working Memory, Elithorn
Mazes - NEPSY-II Animal Sorting, Clocks, Design
- Fluency, Inhibition,
Statue, Fingertip - Tapping, Manual Motor
Sequences - D-KEFS
- Category Tests
- Trail Making Tests
- Tower Tests
68Speed and Efficiency
69Speed and Efficiency
- The Speed of Information Processing
- Multiple Neurological Factors
- Myelination more efficient faster processing
- Ventral Stream Rapid Automatic Naming
- Integrity of any given system
70Speed and Efficiency
- Cognitive Efficiency
- Processing Speed
- Cognitive Fluency
71Speed, Efficiency Fluency Tests
- Processing Speed
- WISC-IV Processing Speed Index
- WJ-III Processing Speed Cluster
- NEPSY Completions Times on Speeded
- Naming Visuomotor
Precision - Cognitive Efficiency
- WJ-III Cognitive Efficiency Cluster
- Cognitive Fluency
- WJ-III Cognitive Fluency CLuster
72Appendix II Correlating Processing with Academics
73Portion of 101 Not on LD Form
- Instruments used for determining processing
disorders must have peer reviewed, scientific
research documentation independent of that
provided in the test manual that supports a
correlation between the processing problem and
the academic deficit Such tests may include
measures of memory, phonological skills,
processing speed as well as other measures which
explicitly test psychological processing
74(No Transcript)
75Why this was left out of the SLD Document
- We did not include the question requiring the
connection between the processing disorder and
the educational deficits. Technically I suppose
that is a proper question, but I do not encourage
adding it to the document. I think it will direct
teams into unanswerable areas too often.
76Complex
- Multiple Psychological Processes correlated with
each academic skill - Phonological Processing is not the ONLY
psychological process correlated with reading - Not ALL poor readers have deficits in
phonological processing -
77Definitive Research
- Research has identified which
- Specific psychological processes
- are correlated with each
- Specific academic sub-skills
78The List
- Is there a list of which psychological processes
are correlated with which academic deficit? - Ongoing Research
- Different Theoretical Models Different Lists
79Process Correlation Charts
- Appendix II pages 15 18
- Disclaimer - page 16
- School Neuropsych Chart - page 17
- C-H-C Chart - page 18
80School Neuropsychology Chart
- No Single List in this rapidly advancing field
- Appendix II Developed in conjunction with
- Dr. Steve Feiffer
- Provides one framework for correlating processes
with academics
81Basic Reading Skills
- Decoding Sight Word Reading
- Attention
- Visual-Spatial Orthographic Processing
- Auditory Phonological Processing
- Expressive Language Retrieval Fluency
- Verbal Memory
- Visual Memory
- Working Memory
82New Assessment Model
- Do the new SLD Identification Criteria
- require
- A new model of psychoeducational assessment?
83Discrepancy ModelAssessment
- Focus on full scale IQ
- WISC, WJ, SB, etc.
- Organize evaluation by model of test
- Wechsler Verbal Comprehension
- Perceptual Reasoning
- Working Memory
- Processing Speed
- WJ-III C-H-C Model
84Discrepancy ModelAssessment Report
- Organize results by test
- IQ (WISC, WJ, etc)
- VMI or Bender
- Checklists (BASC, ADD scales, etc.)
85Referral Specific Assessment
- Select which areas of conceptual model to assess
depending on referral question - Assess Processes research has correlated with the
specific educational concerns - Example Cognitive-Hypothesis-Testing
- Hale Fiorello School Neuropsychology
- A Practitioners
Handbook
86Cognitive Hypothesis Testing
- Develop hypothesis of processing disorder
- Administer tests measuring these processes
- Examine Input
- Output
- Processing
demands of each test - Evaluate validity of hypothesis
- Accept hypothesis
- Reject Hypothesis
- Develop New Hypothesis
87Correlation Charts
- Review all processing areas correlated with
specific academic skill deficit(s) - Make a list of the processes you plan to assess
- Identify tests that measure these specific skills
88Assessment Tools
- Typically more than 1 test will be required
- Not necessary to always administer entire test
- Ensure that you have at least 2 subtests to
measure each process
89Example
- 7 year old 2nd grade student
- Referral Concerns - delays in basic
- reading
and spelling - History - ear infections and articulation delays
- Observations Inconsistent attention
90Traditional Assesment
- Administer WISC-IV, Bender Brown ADD
- Results Verbal Comprehension 100
- Perceptual Reasoning - 108
- Working Memory - 94
- Processing Speed - 128
- Full Scale IQ - 109
- Bender Gestalt Test -
96 - Brown ADD Scales - lt57
91Determination
- No Processing Disorder Identified
- Answer NO on Question 1 of SLD Document
- Do not proceed any further on SLD document
- Determination No SLD
92Referral Specific Assessment
- Include measures from Correlation Chart for Basic
Reading Skills Spelling - Add Phonological Processing
- PAL Phonological Index 70
- Rapid Automatic Naming
- PAL RAN Index 100
93Determination
- Disorder - Phonological Processing
- Severity SS70 gt1.5 SD lt Mean
- Correlated - Basic Reading and
- Spelling
- Question 1 on SLD Form YES
94Math Deficit
- What if the same student had a deficit in
-
- Math Calculation?
95Research Based Correlation
- Cognitive Academic
- Pr0cesses Skill
- Phonological
Reading - Processing
Decoding - Phonological
Math - Processing
Calculation
96C-H-C Correlation Chart
- Drives assessment process
- Related to referral question
- Appendix II, page 18
97Cross-Battery Assessment Process
- Well defined referral question
- Reading
- Math
- Written expression
- Consult XBA chart (page 18). This provides my
theoretical model of assessment. - Narrow abilities are important
- Determine broad and narrow abilities that are
correlated with target academic area
98XBA Process
- Choose tests that assess processing skills
- Start with cognitive assessment
- Fill out spreadsheet for analysis
- Supplement basic battery if/when needed
- 2 subtests are sufficient for each broad ability
area as long as scores are consistent. - Administer additional subtests if scores vary
(approx. 15 points).
99XBA Process
- Compare composite scores in view of the LD
document and your referral question - Is there enough data to make a defensible
decision? - If not, resolve questions with additional tests
- Look for patterns
- Note whether there are 2 composites that range
from 77-85 or 1 composite gt77 - Refer to strong and moderate correlations
- Correlations meet criteria for pattern of
strengths and weaknesses
100Reading
- Gf (Fluid Intelligence)
- Gc (Crystallized Intelligence/Comprehension)
- Gsm (particularly Working Memory)
- Ga (Auditory Processing)
- Glr (particularly RAN)
- Gs (Processing Speed)
101Mathematics
- Gf (Fluid Intelligence)
- Gc (Crystallized Intelligence/Comprehension)
- Gsm (particularly Working Memory)
- Gv (Visual Processing)
- Gs (Processing Speed)
102Writing
- Gf (Fluid Intelligence)
- Gc (Crystallized Intelligence/Comprehension)
- Gsm (particularly Working Memory)
- Ga (Auditory Processing)
- Glr (particularly RAN)
- Gs (Processing Speed)
103- Reading
- WISC and CTOPP
- Supplement for Retrieval
- Writing
- WISC and CTOPP
- Supplement for General Knowledge and Retrieval
- Math
- WISC
- Supplement for Fluid Intelligence
104- Defensible
- Time and Resource Efficient
- Limited number of tools necessary
- Theory Driven
105Appendix III
- Specific processes are evaluated through multiple
measures - Two subtests are sufficient when scores are
consistent - Variable scores require additional assessment of
similar constructs to resolve inconsistencies - Scores are averaged to obtain mean score
- Scaled scores must be converted to Standard Scores
106- Processing deficits are identified statistically
- A single deficit is sufficient for eligibility if
the composite score is at least 1 ½ standard
deviations below the mean of the test (gt78) - Two deficits are required for eligibility if
composite scores are 1 standard deviation below
the mean of the test (77-85)
107Appendix IV
- Know the statistics of your batteries
- Standard Deviation calculations are important
when determining the level of deficit
108Question 2
- For children in grades 4 12 Has the student
obtained a composite standardized score no lower
than 1.5 SDltMean on at least 1 index or scale of
cognitive functioning - Not in IDEA - Maine Specific - Task Force
- Slow Learners
109Additional Requirements
- From a standardized measure of general cognitive
ability - At least 3 subtests
- Answers the Full Scale vs Index Score debate
- Appendix V - Index Score Examples
- Pages 25 - 28
110Examples
- WISC-IV
- Verbal Comprehension - Yes
- Perceptual Reasoning - Yes
- Working Memory - No
- Processing Speed - No
111More Examples
- WJ-III
- General Intellectual Ability - Yes
- Brief Intellectual Ability - Yes
- Thinking Ability - Yes
- Auditory Processing - No
112Standard Deviation Calculations
- No lower than 1.5 SD lt Mean
- Typical SS 100 w/SD 15
-
100 22 78 - Reference chart on page 22 for tests with
different standard deviations
113Question 3
- Is the student achieving adequately for the
students age or meeting State approved grade
level standards in all of the areas below, when
provided with learning experiences and
instruction appropriate for the students age or
State approved grade level standards?
114- .. from Chapter 101
- The IEP Team may determine that a student has a
specific learning disability if
115-
- When provided with learning experiences
appropriate for the students age and ability
levels, the student does not achieve commensurate
with age and ability levels in one or more of the
following areas
116Academic Achievement
- Oral Expression
- Listening Comprehension
- Written Expression
- Basic Reading Skill
- Reading Fluency
- Reading Comprehension
- Mathematics Calculation
- Mathematics Problem Solving
117Academic Achievement
- Question 3 LD document (handout, page 5)
- Achievement relative to age
- Standardized assessment (Appendix VI, page 30)
- Achievement relative to State-approved standards
- Local and state-level assessment (Appendix VII,
page 36) - Districts must develop defensible means for
measuring progress
118Academic Achievement
- Appendix VI lists a variety of standardized
instruments that can be used to assess the areas
of achievement that are to be considered with
suggestions for how to assess - Appendix VII gives some guidance on how to
determine adequate achievement
119Pre-Referral Procedures
- .from Chapter 101
- Data from the pre-referral procedures utilizing
research based intervention techniques indicate
that the response to general education
intervention is not adequate.
120Question 4a
- Item 4a LD document (handout, page 6)
- By 2010 Lack of Response to Intervention must
be documented to determine eligibility as a
student with SLD - Regular Education initiative
- Pre-referral procedures in Chapter 101 Appendix
VIII - Me State RTI/Pre-Referral Guide
- www.maine.gov/education/rti/index.shtml
121- For SLD eligibility, academic intervention is
required - Lack of response
- Positive response that requires an amount of
intervention that replicates specialized
instruction - Children who are not disabled will likely make
progress - Children without disabilities (i.e. processing
disorders) will be ruled out prior to this stage
of decision making - Appendix IX Closing the Gap
122Question 4b
- A Pattern of Strengths and Weaknesses in
Performance, Achievement or Both - Reading Skills
-
- Math Skills
- Pages 5 6 and Appendix X (pages 41 45)
123Relevant to SLD
- That is determined by the IEP Team
- To be relevant to the identification of a
specific learning disability - Maine Guidance Required Research Based
Correlation between Processing Disorder and
Achievement Deficit - Other research based patterns
124Strengths Weaknesses
- Performance
- And/or Relative To
Age - Achievement
- Standardized Age Normed Test Results
125Example
- WJ-III Age Normed Scores
- Strengths Math Composite 103
- Written Expression
- 98 - Weaknesses Basic Reading - 77
- Reading Fluency
- 79 - Reading
Comprehension- 75
126Strengths Weaknesses
- Performance State
-
Approved - And/or Relative To
Grade -
Level - Achievement
Standards - Curriculum Based Measures and other
assessments aligned with the Maine Learning
Results
127Examples
- District benchmark assessments based on MLR
- Strengths Math Meets in all areas
- Writing Meets in
all areas -
except spelling - Weaknesses Spelling - Does Not Meet
- Reading Does Not
Meet
128Strengths Weaknesses
- Performance
-
- And/or Relative To
Intellectual -
Development - Achievement
- Results of cognitive assessment
129Example
- WJ-III and WISC-IV Age Normed Scores
- Strengths Verbal Comprehension 104
- Reading Scores
98 102 - Weaknesses Perceptual Reasoning - 80
- Math Calculation
- 78 -
130Concordance - Discordance
- Academic Processing
- Strength Strength
-
- Academic Processing
- Deficit Deficit
- Hale Fiorello School Neuropsychology
131Conclusion
- References - Page 45
- Contacts
- susan_holinger_at_maranacook.org
- rhcrowell_at_yahoo.com