When parents suspect that their children have difficulty in reading, most parents and teachers take the constructive step of providing more practice in reading at school and at home. When this step is not fruitful, it is time to ask if a learning disability is present. The assessment for problems in reading requires tests for reading and intelligence level. A youngster's reading ability should roughly match his or her intelligence level.
The general strategy in successful testing in preparation for an IEP is to reveal a clear line of evidence from the difficulty in the classroom to difficulties in underlying skills to impairments in subcomponent skills or associated secondary cognitive skills to impairments in basic cognitive skills. The parent can ask for clarification of what each test directly measures and make meaningful contribution to the assessment process. A few guidelines will help the parent understand how to assess the tests.
Classroom Performance Below Intelligence Level Expectations
A Psychological, Cognitive Deficit
A Learning Disability
The first step in the assessment of a reading problem is to determine if the reading level is delayed in comparison to intelligence. There are several different intelligence tests. The choice of which intelligence test to use should be informed by the suspected area of disability. That is, an intelligence test which allows for assessment in an area less affected by the suspected disability should be used. Otherwise, the estimate of intelligence will be contaminated by the disability and decision makers will be possibly caught in a dilemma of what is the level of a student's "real" intelligence. For example, the Wechsler series of intelligence tests have two component scales which combine to make up the "Full Scale IQ" score: a Verbal Scale and nonverbal (Performance) Scale. The student with a language disability may score quite a bit lower on the Verbal Scale, thus lowering the overall "Full Scale" score. On the other hand simply using the Comprehensive Test of Nonverbal Intelligence may substantially bypass the disability. Or, the Stanford Binet IV may allow providing credit for an answer the youngster has difficulty expressing, thereby providing a verbal intelligence score less dominated by expressive-language difficulties.
It should be realized however, that there is no way to entirely bypass a cognitive disability. The brain functions as a unified organ and an injury in one location more or less affects the quality of thinking in all other areas. For example, the difficulty in sequential reasoning and memory which is common to language disorders may affect the ability to reason through a problem in constructing visual patterns. The student may attempt to sequentially think through the steps of a complex problem rather than rely on the innate intuition which might be sufficient for a simple problem. It is just that the "spatial" problems rely less on language or sequential processing skills than expressive-language tasks or other verbal tasks. Any specific test places more or less demand on particular skills but can never be assumed to be totally free of influence from a particular disability.
Once an estimate of intelligence is reached, it can then be used as a comparison for measuring the severity of delay in reading development. The traditional intelligence tests were developed to predict success in school and the achievement test scales are almost always placed on a similar measurement scale so the numbers should match with only slight adjustments.
The test for the assessment of reading level depends on the age of the child. Early elementary children whose curriculum is mainly involved in learning basic reading skills should be assessed in reading word mastery. The ability to rapidly pronounce words is essential for a reading level which can relied on for effortless reading. The Woodcock series reading tests are widely used for this purpose and are very useful in this regard. These tests require that a child correctly read a word within 5 seconds. In another subtest in the Woodcock series, the student is asked to read "nonsense" words so that phonic mastery can be assessed independently of "naming" a word which is visually recognized without sounding out the word. In early grades, some children will have memorized words without really mastering the phonic code; this leaves them vulnerable to reading problems in later grades and ongoing spelling problems. In the need to save time, examiners will often administer the word reading list but not the nonsense word list thereby missing diagnosis of early nonreaders who are simply memorizing words.
The objective in choosing a test is to provide an objective, standardized assessment of the skills needed for success in the classroom or curriculum. When an older student is being asked to read, the youngster is expected to read paragraphs or multiparagraph material. Therefore, an adequate reading assessment must include paragraph reading material. Otherwise, the student is not being assessed on the real requirements for success in the classroom. Success in the task of reading a paragraph or longer material in class or for homework depends on:
- reading speed,
- reading accuracy,
- the ability to sustain concentration while reading,
- comprehension of the material, and
- retention of what is read
A weakness in any of these factors in reading will lower the likelihood of successful reading. For example, the slow reader will tend to avoid reading because it is too time consuming. Usually more than one reading test will be needed to cover all these areas of reading. The Gray Oral Reading Test-3 measures oral reading speed, reading accuracy, short-term retention, and comprehension. However, some students may be inhibited by the requirement for oral reading and comprehension must be measured through a test which allows for silent reading (such as the Kaufman Test of Education Achievement). However, silent reading does not allow for an assessment of reading accuracy or speed.
The Woodcock Paragraph Comprehension test is not recommended as a measure for paragraph comprehension as most items require reading only a single sentence. If your student is unable to comprehend meaning at this level, then the WJ-R Paragraph Comprehension test would be appropriate. Students with language disorders are prime candidates for this test as they often display difficulties in understanding the subtle meaning of phrases and the meaning carried in sentence structure. However, a paragraph reading test would still be in order to document difficulties at each level of complexity so that all levels can be addressed in the curriculum.
The next step in the assessment process is to specify the underlying cause of the reading problem. Often, an educated guess can be made on the basis of the intelligence test and its component subtests. Often, separate tests will have to be given to document that the impairment in reading is caused by an impaired cognitive process. The underlying problem is often a difficulty in sequential memory although sometimes inadequate hearing discrimination of sounds is the cause. In other cases, memory for what is seen or confusion in right-left directionality can be the culprit. There may be many underlying causes but most can be assessed through the testing process.
In many cases, an attention disorder can impair reading. An attention disorder which is inadequately treated can impair the rate of learning due to difficulties in "working" memory. Working memory is the ability to hold information in mind while you think and is considered to be a core problem for attention disorders. Even with adequate treatment, an attention disorder can also frequently cause disorganization in the expression of complex ideas in writing or impairments in paragraph reading comprehension through inadequate organization of ideas or impaired memory. Attention disorder is an especially important cause of reading problems in teenagers who have not been previously diagnosed with a reading disorder in elementary school.
Sometimes, the teacher reports grade-level reading even though all tests show the student to be a deficient reader. You can ask that the school examiner obtain a tape-recorded sample of reading of never previously read material and a sample that the class has already covered. The reading should be conducted with a awareness by the student that comprehension questions will be asked so that effort to comprehend the material is applied during the reading. You might also ask an independent reading specialist to conduct this assessment and compare performance to age-group expectations.
The student who has been retained presents a problem for examiners. Is the examination to be based on age-level or grade-level norms? Each basis of comparison has its advantages and disadvantages. The retained student should be compared to age-level norms as reading is less tied to specific academic instruction than, say, arithmetic.
Much of learning is self-teaching. The instructor in the classroom can only present a brief exposure to material. A child's ability to learn in the classroom environment depends on the ability to register what the teacher is presenting and integrate that information into what is needed in the reading development process.
Emotional problems can interfere with learning. Often, emotional problems coexist with learning disabilities. It is important to discriminate whether the emotions cause the impairment in learning, are caused by the learning impairment, or are present independent of the learning impairment. To make this discrimination, a careful history and assessment is needed to document the chronology of problems, the nature of the problems, and the situations under which the difficulties are observed. It is useful to document when symptoms are produced: only in the classroom or throughout the student's Iife. Frequently the learning disabled child will be much happier in the summer when not in school. Stomach aches and headaches may occur only on school days. Symptoms which are caused by school problems build up after school starts in September and usually occur only on school days, often after school rather than before school, but anticipatory anxiety can cause problems before school each day.
While it may be tempting to rely on a standard set of reading tests, it is important to use common sense in combination with technical expertise in assessing learning disabilities. The professional can bring the technical expertise to the assessment, but the parent can contribute common sense to the assessment plan. Together, a more meaningful assessment can be crafted.
Marc D. Lewkowicz Ph.D., clinical and neuropsychologist, is the LDA-CA Governmental Affairs CYA (California Youth Authority) Representative.
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