PART 1. INTRODUCTION AND OVERVIEW - Schedschd.ws/hosted_files/aet2014nationalconference/46/A2...

1© 2014 Ann P. Kaganoff, PhD, BCET All rights reserved.

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The Case Study as a Vehicle

For Exploring Essential Questions

About Best Practices in Educational Therapy

AET 36th Annual Conference

October 24, 2014

Anaheim, California

Ann P. Kaganoff, PhD, BCET, FAET

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The Case Study as a Vehicle For Exploring Essential Questions

About Best Practices in Educational Therapy

� Part 1. Introduction and Overview

� Part 2. Reasons for Choosing this Case as a Vehicle for Essential Questions

� Part 3. Client information; Essential Questions

� Part 4. School history; Essential Questions

� Part 5. Assessment and Intervention History/Phases; Specific Decision Points in Treatment; Essential Questions & Best Practices

� Part 6. Anticipated Issues for 8th Grade: Questions to Ponder

� Part 7. Reflections on “How I do what I do”

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PART 1. INTRODUCTION AND

OVERVIEW

� This workshop is a “work in progress,” an attempt to show how all of our cases, no matter how different, each embody important educational therapy principles.

� It is based upon a presentation originally made to a study group in January 2014, along with ongoing study group discussions, my own work, and listening to other ET’s talk about shared problems.

� It is intended to raise questions that need to be asked as we proceed with our treatment plans. You will be invited to join with me as we walk through the essential questions of the case by 1) having a notepad ready for journaling your own responses; 2) discussing together; and 3) identifying questions that must be pondered over time. Watch for slide items coded J for journal, D for discuss, and P for ponder.


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GOALS OF THE WORKSHOP

� Explore important ethical, assessment and instructional considerations in the conduct of a specific case, that may shed light on our own decision-making processes in comparable or differing cases

� Identify potential “indicators” that are used in educational therapy as the basis of decision-making for diagnostic intervention, and for modification of the treatment plan

� Review specific and general “best practices” in educational therapy

� Generate interest and expertise for a more wide-spread use of case study analysis in workshops and study groups

� Inspire participants to begin the Case Study component of the BCET process

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CONFIDENTIALITY

� Please note that all case study information is confidential. Any information shared in this presentation is privileged, including possible identifying material about the client, as well as information about the client's school, services provided, or outcomes. Identifying information has been masked or changed. This presentation generally follows the outline for case studies required for advancement to Board Certification by AET.

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HOW SHOULD THIS CASE STUDY ANALYSIS FRAMEWORK BE USED IN AN EDUCATIONAL THERAPY PRACTICE?

� 1) For experienced educational therapists, case study analysis can help us to maintain our perspective on any given case, as well as to help us reflect upon how we use our knowledge and our experience to assist all clients.

� 2) For those in the beginning stages of educational therapy, the framework serves as a guide for discovering what areas of expertise they need to develop. It is the master plan for what we need to pay attention to.


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BENEFITS OF WRITING THE CASE STUDY (Marshall and Kaganoff, Annual Conference Certification Workshops, 2008 - 2014)

� Provides an opportunity for self-observation

� Provides a way to evaluate your strengths as an educational therapist, and find areas of your practice that you wish to fine-tune

� Creates a document against which you measure your other cases

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PART 2A. REASONS FOR CHOOSING THIS CASE: CLIENT CHARACTERISTICS AND INTERVENTION HISTORY

• Represents important decision-making dilemmas in educational therapy

• A chance to further review my own goals and decisions (this case is ongoing)

• A client with inconsistent presentation and uneven progress; an intriguing puzzle

• Very supportive family

• Major shift in treatment plan at beginning of 7th grade (3rd

year with client)

• Case management challenges: good communication with pediatric psychiatrist but persisting concerns about other additional specialists to recommend (how much is “enough”?)

• Anticipated challenges in 8th grade

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2B. REASONS FOR CHOOSING THIS CASE: SCHOOL PLACEMENT

� Persistent concerns about placement: degree of progress unequal to demands of school situation (always working in a frustration mode at school)

� Progress evaluation relative to school demands and relative to standards for non-private school population: a moving yardstick

� Difficulties with implementing intervention at the level needed

� Current school is K-8. Significant transition challenge in 2015 for high school


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ESSENTIAL QUESTIONS: PART TWO

� J: Is every client a “case study”?

� J: When is it inappropriate to generalize from one case to another? Do you have a specific example?

� D: Do some cases require us to use more strategies and more creative problem solving than others?

� P: How do we maintain perspective on our own cases without direct observation of how other ET’s work?

� P: Is there a library of formal case studies available? Should there be such a library?

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PART 3: CLIENT INFORMATION (as of Fall 2014)

� Date of birth: X-25-2001

� Age: 13 years, x months

� Current grade in school: Entering 8th grade

� School placement: Independent school

(grades K-8), Southern California, from 3rd

grade to spring 2014, with intent to finish

8th grade at this school (in 2015)

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3A. REASONS FOR REFERRAL: PRESENTING PROBLEMS

� October 2011: J was referred for an educational assessment at the recommendation of the head of XX School

� Stated concerns included J’s reading skills: “Seems to be ‘delayed’ in reading. Reading rate is slow; does not enjoy reading; rarely chooses to read.”

� Health history included speech therapy from age 3 to 5, which was discontinued “when he no longer needed it.”

� J: What hypotheses arise at this point? What do we need to verify? What are we going to pay attention to as we proceed? Is there a link between reading and language delay?


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ESSENTIAL QUESTIONS:REASONS FOR REFERRAL

� D: What other issues should the ET immediately consider when client presents as a “reading” problem? How do you track your thoughts as you formulate hypotheses?

� J: How much weight should the ET place upon the parents’ initial estimate of the problem?

� P: What questions should the ET ask about a student who has never been referred for an educational assessment? (Parent denial; not a common practice or part of the school culture at the specific school; problems too subtle? You will need to watch for all of these as an ET)

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3B. FAMILY BACKGROUND, PREVIOUS INTERVENTIONS (October 2011)

� Speech delay noted when he was slow to begin talking; speech therapy from age 3 to age 5. Therapy discontinued “when no longer needed” (parent report)

� Speech delay had a negative effect on his self confidence, which seems to persist (parent report).

� Expressive language often difficult to understand; mumbles and frequently is asked to repeat what he said.

� Early reading instruction at the first independent school seemed to progress well, though parent felt the program was “strict and rigid” in nature.

� No academic evaluation recommended until 5th grade. "Grades are satisfactory; he tries his best” (per school report)

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3B. PRESENTING CHARACTERISTICS, PERSONAL

� Only child; mother is a “full-time mom;” father in

the medical profession. Very close family.

� Slight in build, clear eyes

� Gentle demeanor

� Soft spoken; often difficult to understand

� Seems to fatigue easily

� Loves tennis, takes tennis lessons

� Face lights up when he sees his mom, his dog


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3C. EDUCATIONAL EVALUATION, OCTOBER 11, 18, 21

� No previous testing data available on I.Q., cognitive levels, attention, memory, processing delays, etc.

� Assessment was divided over 3 meetings, because J’s mom was very concerned that he would be “fearful with a stranger.”

� Based upon available data and family concerns, it was decided to focus on what can be measured “informally” instead of recommending a battery of formal tests. A series of performance-based measures were used over the three testing dates.

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PERFORMANCE-BASED MEASURES USED

� Slosson Intelligence Test-Revised (as a screening measure, gives a range to indicate need for further testing; provides reading-related data such as acquired knowledge, ability to respond to questions, verbal explanations)

� Raven Coloured Progressive Matrices Test (used here as a screening measure for non-verbal logical reasoning)

� Informal Reading Inventory (Burns Roe Informal Reading Inventory, with selected reading passages from the 2nd to 8th Editions)

� Writing sample

� Interest Inventory (Kaganoff: The Educational Therapist)

� Diagnostic Cloze Passage

� Study Skills Inventory (Kaganoff: The Educational Therapist)

� Wepman Test of Auditory Discrimination

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ASSESSMENT RESULTS

� SIT-R I.Q.: Average to high average range

� Raven: High average range

� Informal Reading Inventory: Independent at 3rd grade; Instructional level at early 4th; Frustration level at 5th.

� IRI Reading Level: One full year below grade level. (J: What should I ask about this deficit, given the reading demands of much of the reading material at XX School?)

� IRI Word recognition: weak in decoding multisyllabic words

� IRI Comprehension: weak in all areas (main idea, inference, detail, vocabulary, sequence, cause/effect)

� Listening comprehension: same weaknesses as in reading comp

� Writing: Unable to demonstrate use of “academic” vocabulary; simple sentences, little elaboration

� Language development: difficulty with processing complex patterns in both listening and reading comprehension, as well as in writing


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INITIAL IMPRESSIONS, ASSESSMENT COMMENTS AND OBSERVATIONS

� Engaged easily with the examiner. High level of interest and curiosity (J: Was this a function of the 1-on-1 situation? What was I doing to enable him to display this kind of strength?)

� Enriched experience background based on family travel and other activities

� Responded well to questions with intact, organized sentences (J: Was this characteristic a function of the testing situation, as it subsequently proved to be very inconsistent). Adequate functional vocabulary; tended to define words by their associations, not by synonyms.

� Difficulty generalizing in response to application questions

� Limited auditory memory for repeating exact sentences (speech and language delay?) and for storing and repeating a series of random numbers.

� D: What should an ET be asking, given the above data? How do I work the data?

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REFLECTIONS BASED UPON SUBSEQUENT INSTRUCTION (Dec. 2011)

� Apparent strength in verbal and reasoning skills at the time of the evaluation did not hold up as we began more systematic analysis through instructional activities in reading, grammar and critical thinking.

� Verbal weaknesses became more apparent as seen in his writing and grammar exercises.

� Frequent evidence of cognitive “confusion” and weak short-term memory

� Has been in a “grammar rich” environment since 3rd grade, but has gained little understanding of grammar analysis (as required by classroom and homework exercises)

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ESSENTIAL QUESTIONS: INFORMAL ASSESSMENT MEASURES AND RESULTS

� D: What is the purpose of using performance-based measures?

� D: How do Performance-based measures contribute to other types of data?

� D: Are the results as valid as the results of formal assessment measures? How do informal measures complement formal measures?

� D: Are performance-based measures only a snapshot in time, or are they a reliable base-line indicator? How do we document them?

� P: How much weight do we give to first measures, whether formal or informal? Predictive value? Dependent upon a novel circumstance?

� P: How do I build an assessment that gives me the kind of data I need?

� P: How do we document our use of ongoing formative assessment to inform our treatment decisions? How should this type of assessment be communicated to parents/clients?


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PART 4: SCHOOL BACKGROUND

� K-2 at (very) small independent school. Reading

program viewed by parent as “rigid”

� Enrolled in current placement at 3rd grade,

continuing to 8th grade for 2014-2015

� Small class size (16)

� Supportive and safe environment (parents very

apprehensive about a public school placement)

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CURRENT SCHOOL CURRICULUM AND INSTRUCTION CHARACTERISTICS

� Independent school with unusual philosophy and goals

� School does not follow Special Education guidelines and requirements

� Use of very advanced literature selections (“classical” literature) that are typically at J’s frustration level

� Social studies classes taught entirely by lecture, with students expected to “take notes” (no history textbooks are used); science is all lecture and “hands on;” little use of formal “testing” for evaluation

� Social studies curriculum for grades 5-7 rotates through 3 history cycles: ancient, European, American

� Heavy emphasis on formal grammar (5th through 7th

grade); difficult for J to grasp as more complex concepts are introduced, since he does not have the foundation

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THE EDUCATIONAL THERAPIST’S PREVIOUS CONTACTS WITH SCHOOL

� Had conducted observations of other clients enrolled in this program

� Had attended whole staff meetings re: other clients

� Impressed by dedicated staff who all support the school philosophy and instructional approach

� Can intervene because of history at school


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ESSENTIAL QUESTIONS TO PONDER:SCHOOL PLACEMENT (Responses will vary, depending on types and availability of Independent Schools in area)

� What strategies does the ET need to deal with independent schools with “exceptional” curricula or philosophies?

� Do these strategies generalize to more conventional independent schools and/or public school settings?

� Should the ET anticipate having to supplement an “exceptional” curriculum based upon personal judgment?

� What is the role of the ET when a client in a “no homework” school requires substantial outside support?

� What advice should the ET be prepared to give to parents regarding the trade-offs inherent in such a school choice?

� What percentage of educational therapy clients are likely to present these placement problems?

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PART 5: HISTORY OF EDUCATIONAL THERAPY INTERVENTIONS5A. PERIOD OF TREATMENT

� October 2011 to April 2012 @ 2 sessions per week, 1 hour each

� Trip abroad May-June 2012

� Summer Intensive 2012 (June-August) @ daily sessions, 1 hour each, with outside preparation required

� Fall 2012 to June 2013 @ 2 sessions per week, 1 hour each

� Summer 2013: intermittent, for a total of 12 one hour sessions

� Fall 2013 to Spring 2014 @ 1 session per week (with May and June in Europe, as in 2012)

� Summer 2014: Family travel, math tutoring, 1 ET session

� Fall 2014: Resume regular ET sessions @ 1 per week

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5B: OVERALL CONTENT OF EDUCATIONAL THERAPY INTERVENTIONS, OCTOBER 2011 TO SUMMER 2014

� Reading analysis, literature: elements of story in both assigned and independent reading, writing style, connections between literature and historical period

� Reading analysis, expository materials: books of biographies and topical articles, trade books in client interest areas. Instruction in text organization patterns, such as problem/solution, cause/effect, compare/contrast, sequential ordering, time order, main idea/supporting detail, writers’ signal words

� Emphasis on critical thinking skills of inference, main ideas, key ideas, asking own questions, analogies, categorizing

� Study skills using non-classroom materials, such as previewing the content, determining writer’s point of view, etc.


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5B: CONTENT OF EDUCATIONAL THERAPY INTERVENTIONS (cont’d)

� Grammar: parts of speech, sentence diagramming, sentence structure (clauses and phrases, direct and indirect objects, functions of verbs, etc.)

� Ongoing in-session support for take-home exercises and review for weekly tests inVocabulary from Classical Roots (EPS)

� Vocabulary in context: literature, non-fiction materials

� Words with multiple meanings

� Decoding multisyllabic words

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5B: CONTENT OF EDUCATIONAL THERAPY INTERVENTIONS (cont’d)

� Writing expository paragraphs: example, process, reason, persuasion, compare/contrast, cause/effect, descriptive and narrative paragraphs

� Assistance with school required writing assignments such as in-class essays

� Exercises in reasoning skills, including structure of definitions, categorizing, generalizations

� Assistance with preparation for class presentations

� Interpretation of classroom assignments

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5C. PHASES OF TREATMENT:PHASE ONE

Planned interventions (school year 2011-2012, 5th

grade):

� Lesson plan based, continuity within ET planned program elements

� Frequent utilization of school assignments as appropriate; coordination with school staff to adapt assignments

� High level of parent involvement required for completion of homework

� Grades adequate, teacher feedback generally positive

� Able to adapt and adjust our “planned” lessons as needed


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5C: SPECIFIC DECISION POINTS IN PHASE ONE (OCTOBER 2011)

October 2011. First indicators of serious attention issues:

� Uneven performance in sessions

� Discrepancy between performance on session tasks and performance on initial assessment measures

� Inconsistent perceptions of school tasks and inability to explain or grasp homework assignments

� Classroom observation requested and scheduled, early November

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PHASE ONE: NOVEMBER 2011

November 2011: Classroom observation (grammar/literature)

� Pace of instruction appropriate, teacher very supportive

� Client willing to request help when needed

� Participation attempts indicated he was not following instruction; answers often off the mark, as if he was answering another question on another topic

� Level of energy seemed below that of the rest of the children in the class (head down on desk)

� Seemed unaware of critical points of book chapter under discussion, though we had discussed at some length the previous day in session

� Difficulties with expressive language (teacher noted that this occurs not only in the classroom, but also in playground interactions with other children)

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PHASE ONE: NOVEMBER 2011 (cont’d)

November 2011: Emerging concerns

� Distractibility

� Weak mental energy; uneven mental alerting system; spacing out during instruction (variable across tasks)

� Tendency to have head down frequently (indicator of low physical energy?)

� Signs of cognitive overload

� Rapid alternation between engagement and disengagement, which may account for the apparent “holes” in his knowledge base


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SESSION NOTES: NOVEMBER 8, 2011

� Introduction of Rules of the Game, Book 1(grammar series, EPS): Need to approach this very systematically. He has a limited sense of word function, limited sense of words with multiple meanings. Fatigues easily, needs very close monitoring with each step.

� Needs directions repeated several times and then still seems puzzled. Responds well to guidance, but needs a lot of it.

� Responses often seem arbitrary, illogical…

� Written sentences very disorganized

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PHASE ONE: PARENT CONFERENCE, NOVEMBER 2011

Late November 2011. Scheduled (formal) Parent conference with specific recommendations:

� Medical evaluation for issues of attention, lack of focus, distractibility, inconsistent alerting

� Add additional session of educational therapy as soon as available

� Develop different strategies for parent involvement in book reading; both parents to pre-read all books to better promote “book conversations”

� Set conditions for daily reading practice to promote independence; transition away from out-loud reading

� Engage parents in better language modeling

� Assist client to develop conscious strategies for self monitoring of language output

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PHASE ONE: NOVEMBER/DECEMBER 2011 (cont’d)

November/December 2011: Conference outcomes� Strong emotional reaction from both parents to the

recommendation for a medical evaluation

� Immediate consultation with Pediatric Psychiatrist who diagnosed ADD and prescribed medication

� Unsolicited observations from tennis coach that J seems suddenly “much more focused”

� Both parents observed more clarity of oral expression and better focus; email from Dad (to Maui, 12-2011) that “a miracle has occurred”

� Emerging explanation for why previous learning has been so spotty; link between ADD and language processing (see Slide #33)


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ESSENTIAL QUESTIONS: AS OF FIRST THREE MONTHS OF TREATMENT

� D: Why had the now-obvious ADD symptoms never been formally picked up?

� D: Role of the teachers at school in noting the inconsistent behavior (remember that the client was first referred for a “reading problem” and that the school does not have Special Education trained personnel)?

� P: Questions re: “goodness of fit” with this client and the type of school. What are acceptable trade-offs?

� J: Should J’s pediatrician have been consulted earlier about inconsistent alertness?

� P: Should the expressive language difficulties have been a trigger for an educational assessment?

� P: How should ET prioritize needs, given their pervasive nature through all aspect of learning?

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PHASE ONE CONTINUES INTO THE NEW YEAR, 2012

Clients are asked to write their goals for the New Year, January 3, 2012:

� Read faster

� Answer faster

� Work faster

� Understanding xbox 360 w/kinect

J: What do these goals reflect about client’s self-awareness?

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SESSION NOTES 1-6-2012

Next literature book: The Golden Goblet (McGraw)

� Had marked the word “aghast” as a word he did

not know, but as he tried to look it up in the

dictionary, did not know alphabetical order, did

not know how to use guide words, does not have a

home dictionary

� Book is way over his head; needs all kinds of

systematic help beyond what he gets at school;

continued evidence of limited academic skills


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PART 5D: 5th GRADE PROGRESS AND ONGOING CONCERNS

� January – April: Consistent ET sessions, better engagement, some improvement noted in school reading performance

� Consistent medication monitoring by pediatric psychiatrist

� Written sentences continue to be scrambled and often illogical in content

� Spoken language difficult to follow; mumbles, offers partial sentences and then stops and waits for help

� Often seems fatigued and overwhelmed by school demands

� Both parents (separately) invited to sit in on sessions and observe language modeling and feedback provided

� Speech/language evaluation has been mentioned but seems too much to add at this time

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END OF PHASE ONE: ITALY

� May 2012: Family trip to Italy. Time was taken off from school with the condition that J would do a “summer intensive” (educational therapy sessions plus math tutoring) to make up for time away from school

� We used some session time to review the geography and places they expected to visit.

� He took 2 books to read, and a practice book on analogies.

� Interesting changes in J’s level of engagement and alertness, as seen in photos from Italy!

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5D: PHASE TWO, SUMMER INTENSIVE (SUMMER 2012)

Summer intensive, June – August, 1 hour daily

� In-depth reading and writing to prepare for 6th grade, with “homework”

� Consistent reinforcement and demonstrable progress

� Many opportunities for the use of ongoing formative assessment to shape our collaborative work

� Utilization of client interests for expository reading analysis, selection of reading materials and literature at client instructional level

� More independence from parental support

� Continued with afternoon tennis lessons and daily math tutor to make up the missed math work


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5D: SUMMER INTENSIVE OBSERVATIONS

� Daily reinforcement was significantly helpful.

� Able to choose books at his instructional and interest level: The Enormous Egg, The Giver, My Side of the Mountain, Mrs. Frisby and the Rats of NIMH, etc.

� Reasoning skills: words with multiple meanings, analogies, inference

� Expository writing: going beyond sentence writing to types of paragraph development

� Non-fiction reading in areas of interest (biographies, tennis, animals)

� Preparing for 6th grade grammar, writing, vocabulary

� 6th grade book list: King Arthur, Anna of Byzantium, Beowulf, Queen Eleanor, etc. (European history)

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SUMMER INTENSIVE TRACKING GRID

MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY

Writing

Chapter

book

Reading

analysis

Megawords

Reasoning

& Reading

Analogies

Grammar

Expressive

language

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ESSENTIAL QUESTIONS:THE SUMMER INTENSIVE

� P: If a summer intensive is recommended, is the ET prepared to create curriculum in the absence of an ongoing school year curriculum? What materials can be obtained, and what materials must be created?

� P: What is the load of preparation time for the ET?

� J: How do you keep the momentum going?

� D: How do you keep from getting tired of each other? Do we become too familiar?


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QUESTIONS AND CONCERNS AT THE BEGINNING OF 6TH GRADE

� Concerns about stability of improvement: without intensive educational therapy intervention, would regression be possible or likely?

� How would J handle the demands of 6th grade (J still resisting reading independently, with difficult literature selections ahead)?

� Will we see continuing difficulties in all areas of expressive language?

� Should we add another evaluation by a neuropsychologist or speech/language specialist?

� D: What diagnostic indicators should I watch for that might signal a need to modify the intervention for 6th

grade?

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5E: PHASE THREE, 2012-2013, 6TH GRADE (OVERVIEW)

Phase Three, 2 sessions weekly

� Planned intervention ET sessions continue as in 5th grade, with greater need for support of school-based tasks

� Literature selections very difficult, with more parent assistance required (King Arthur, Anna of Byzantium)

� Lecture-based social studies and note taking become more difficult, as teachers stop providing notes

� School writing becomes more of a struggle, with negative feedback from teachers

� Social adjustments included dealing with one instance of a school bully

� Parents begin investigation of a different independent school placement, April 2013

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SEPTEMBER 2012: CONFERENCE WITH SCHOOL HEAD AND STAFF RE: ACCOMMODATIONS FOR 6TH GRADE

� Extended time for tests

� Seating toward front of classroom

� Access to history curriculum topics to integrate history topics with supplementary text materials for text analysis practice

� Advance access to general forms of tests or sample test questions

� Advance access to teacher notes that support history and literature main ideas and topics introduced in class

� Periodic conferencing to integrate school instruction with educational therapy program


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SIXTH GRADE BEGINS, 2012-2013

� Resumption of twice weekly ET sessions

� Increased frequency of Mom’s presence in sessions (wanted to “learn grammar” so she could better help with grammar homework)

� Academic areas of concern: formal grammar (sentence diagramming), challenging literature selections, ongoing difficulties with written expression

� Evaluation by speech/language group was suggested but not yet acted upon

� Teachers were willing to make the requested accommodations, but honestly did not see this boy as having issues!

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EDUCATIONAL THERAPY GOALS FOR SIXTH GRADE

� Maintain close link to school assignments to assess understanding of subject matter

� Develop critical strategies, such as AOQ (asking own questions), “curious reader” questions

� Provide textbook reading to support classroom lectures, if available (did not prove to be practicable, owing to classroom lecture format using material from multiple sources. No match could be made between lecture content and an available textbook.)

� Continue ongoing formative assessment: diagnostic teaching, careful observation, well-crafted session notes, reflection

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6TH GRADE: INTERVENTION PLAN AND INSTRUCTIONAL FOCUS

Planned instructional activities, following ET goals

� Literature analysis and interpretation

� Analysis of expository writing

� Grammar

� Vocabulary from Classical Roots: Support classroom assignments

� Writing expository paragraphs

� Critical thinking exercises

� Categorizing: going from general to specific and back

� Class presentations: Outline, research, written notes, timed presentations


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SESSION NOTES, 9-26-12

� Worked on the links between prefixes and roots. Good discussion of vocabulary and usage, which he is getting much better at. Focus more consistent. Application good. Finished Book 2 (Megawords), sent it home.

� Subject/verb agreement: he was genuinely interested in the topic of the exercise sentences (Bigfoot sightings) and we went from subj/verb to Theories (what is a theory) and Migration questions. Quite amazing questions.

(Source of the exercise: Rules of the Game, Book 1)

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PHASE THREE CONTINUES: THE NEW YEAR (2013)

Clients are asked to write their goals for the

New Year: January 7, 2013:

� Better at reading; remembering what I read

� Better at typing; faster

� Better at responsibility; studying for tests

J: What do these goals reflect about client’s

self-monitoring?

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SPRING 2013: PARENTS RE-EVALUATE SCHOOL PLACEMENT

Factors leading to proposed change in school placement:

� Ongoing sense of a mismatch between J’s learning style, and the more indirect teaching style and philosophy at the school

� Parent concern that their child was missing conventional training in textbook reading and content area testing

� Parent frustration with the high level of support needed to accomplish much of the required work, both from parents themselves and in educational therapy sessions

� A perceived increase in negative feedback from teachers

� Ongoing academic struggles and fatigue from the school day


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SUMMARY PREPARED BY ET IN APRIL 2013 FOR SCHOOL PLACEMENT COUNSELOR AT POTENTIAL NEW SCHOOL

� Academic areas supported to date in Educational

Therapy (see previous slides)

� Areas of achievement and improvement (Slide 56)

� Classroom accommodations needed, as

recommended by school staff and ET (Slide 57)

� Background information to inform new staff at

beginning of 7th grade if placement is changed

(Slide 58)

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AREAS OF ACHIEVEMENT AND IMPROVEMENT, 6TH

GRADE (Quoted from summary)

� Improved awareness of what good readers do; improved inference

� Improved questioning while reading, leading to improved retention

� Vocabulary retention

� Improved focus during instruction

� Improved expressive language, oral and written; better structure, better use of elaboration and detail

� Challenging books completed

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CLASSROOM ACCOMMODATIONS NEEDED FOR 7TH GRADE (Quoted from summary)

� Preferential seating in the classroom

� Access to written notes for complex directions for homework assignments; restatement of directions when needed

� Access to written class notes for material delivered through lecture

� Extended time for formal testing, including the ISEE

� Extended time in the classroom for responses and homework, because of language processing delays

� Advance access to practice tests or sample test questions, to help accustom J to test preparation and formal test writing

� Periodic conferencing with staff to assess progress


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RELEVANT BACKGROUND INFORMATION (Quoted from summary)

� 2011 diagnosis and subsequent treatment for ADD; close monitoring by Dr. S

� High level of support that has been provided to enhance his school learning; homework support provided at home by J’s mother

� Ongoing need for educational therapy support during transition to School B

� History of steady progress, high level of motivation

� Expressive language limitations which often inhibit J’s ability to express what he knows

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IMPLICATIONS OF A CHANGE IN SCHOOL PLACEMENT TO SCHOOL B (APRIL 2013)

� School B is very similar in student environment (small class size, good level of individual attention)

� School B is a member of CAIS, with a more conventional curriculum, textbook based instruction in social studies and science, grade level literature selections, use of formal testing; has a center for “educational therapy” for students

� School B had a space for J, but required incoming students to take the ISEE for admission

� Initial conferences with school counselor were reassuring re: client’s special needs, but parents and ET discussed need for additional test data from a speech/language specialist (this was done, with all findings “in the normal range”)

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QUESTIONS AND CONCERNS ABOUT CHANGE IN SCHOOL PLACEMENT

� Would client be able to pass the ISEE, even with coaching?

� Should he take this test even when coaching indicated the high likelihood he would not pass?

� If admitted, could he shift to a textbook-based model, without prior exposure to and training in textbook learning?

� Would changing his environment add to anxiety about school learning?

� D: What are the predictable trade-offs for remaining in current school placement? What happens after 8th grade?


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SESSION NOTES RE: ISEE PRACTICE

� 5-15-13: Spent entire session on strategies for passages; he needs to be trained to follow a strategy and not get side-tracked by off-topic questions. He varies from focused to scattered. He wanted to review what the test booklet will look like so we did that. Went over strategy tips for passages. He can do this with practice.

� 5-20-13: Went over some sample prompts for the writing test to do some key idea practice. Faced the reality that there may be some topics (on this test) that he has no knowledge about, like voting.

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SCHOOL PLACEMENT DECISION: SUMMER 2013

� Decision was made to remain at current school

� Time spent in session on ISEE practice tests proved both frustrating and discouraging

� Modified summer plan (reduced number and frequency of sessions from previous summer) to reduce school related stress

� Instructional focus on non-fiction, with emphasis on text organization patterns based on a single book: Sea Otter Rescue: The Aftermath of an Oil Spill (the effects of the Exxon Valdez oil spill on the sea otters). By Roland Smith, Puffin Books, 1990, 1999.

� Topical writing

� Literature connected to social studies (American history), such as Johnny Tremaine, Where the Red Fern Grows

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SESSION NOTES, SUMMER 2013

� Reads with good attention when looking for specific text organization patterns. Does especially well with cause/effect and problem/solution. (Sea Otter Rescue: The Aftermath of an Oil Spill)

� Asked many good questions about the geography of Prince William Sound in Alaska, not because he was distracted, but because he really wants to know.

� Is responding well to this very structured approach; is becoming aware of important text organization patterns (cause/effect, sequence, time order, problem/solution, main idea and supporting detail)

� Learning how to annotate text, using photo-copies of pages


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5F: PHASE FOUR, 7TH GRADE TO SUMMER 2014

Phase Four (2013-2014, one hour per week):

� Major shift in approach to task-specific, school assignments-based interventions.

� School-based tasks required much re-teaching, front-loading and interpretation

� Sessions frequently devoted to playing catch-up on frustration-level tasks

� Little client choice in topics for reading activities, though a high level of interest seen for American history

� Feedback from teachers often negative

� Bullying issue was resolved

� High level of parental frustration continues as before

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OCTOBER 2013. CONFERENCE WITH SCHOOL HEAD RE: ONGOING ACCOMMODATIONS

� Staff now very familiar with client’s needs and ongoing classroom accommodations

� No modification of literature selections, which included Witch of Blackbird Pond, Shane, Twelve Angry Men

� Extended time on assignments

� No major shift anticipated in classroom instruction from the classroom lecture format to textbook based (or even textbook supported) instruction for American history

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ESSENTIAL QUESTIONS: BEGINNING OF 7TH GRADE (2013)

� D: How and when in educational therapy sessions

can I introduce use of conventional textbook

reading and study, if not a part of current school

approach? Would this be imposing my own

curriculum?

� P: What proportion of the “planned intervention”

am I willing to give up and still feel that I am

doing educational therapy as defined by AET and

by my own standards?


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MODIFICATIONS, MODIFICATIONS

� Mom begins to sit in on sessions again so we can

plan together and work together, a full team effort

� Writing demands have escalated significantly, and

a great deal of time is spent in writing and re-

writing

� Some issues with an inexperienced teacher,

(addressed in a meeting by parents armed with a

rather forceful list of talking points from ET)

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SESSION NOTES, 9-18-13

� The grammar and vocabulary teachers are writing their own materials (not necessarily a step up from any of the other materials available). It will be hard to manage all the challenges w/ just one session per wk.

� Discussed WBBP: he can do the character list, but still misses on vocabulary and figures of speech, which he takes literally. I advised Mom to change the model of reading with Mom so that J does all reading silently, then they discuss together. (Still trying to wean them off oral reading)

� Writing Teacher giving lots of rules, many of which J copied incorrectly. So much to monitor in so little time.

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OCTOBER 2013: DECISION POINT

� Literature teacher emails parents that J is having so much trouble with Twelve Angry Men that we should consider exempting him from this work, and switching him to an on-line literature program.

� Parents and I agree this will not work because J needs the stimulation of class discussion. We keep J in class.

� We get through Twelve Angry Men and are saved by The Miracle Worker. J loves the play and really understands it. It’s a miracle.


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MORE VICTORIES

� We read To Kill a Mockingbird, with good success

� I slip J a well written US History textbook to support his preparation for a test on the Revolutionary period. I make a reference to Ben Franklin’s trips to London and Paris, and how this travel influenced his contributions to the framing of the Constitution. J reads the whole section in the book, makes a reference to Franklin’s trips on his test, with a surprising reaction from the teacher!

� We read Pygmalion, which J thinks is funny.

� We survive The Count of Monte Cristo.

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END OF PHASE FOUR, MAY 2014: AREAS OF PROGRESS

� On balance, it was a good year. Much progress was made in expressive language and learning strategies.

� Increased ability to support arguments with logic (often a problem in the past when he would take illogical points of view and not budge)

� We learned to deal with school demands that did not always make sense at the time.

� J now communicates with me and others by email, with improvement in writing fluency.

� School year ends early, in May, with a repeat trip to Italy and Spain. All’s well that ends well.

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PART SIX: ANTICIPATED ISSUES FOR 8TH GRADE (QUESTIONS TO PONDER)

� Social studies? What will be the content of the curriculum, given the unconventional approach of the social studies teachers?

� Given the nature of our work last year, how do I set priorities for the 8th grade focus of educational therapy?

� How will I build in self monitoring, self correcting, asking own questions, going beyond the information given?

� Literature: Will we continue to be dealing with materials at J’s frustration level? Cyrano de Bergerac, anyone?

� When do we begin preparation for more conventional textbook based learning, which is likely to be the case in 9th grade?


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PROPOSED FOCUS FOR CONTINUED SUPPORT OF EFFECTIVE LEARNING STRATEGIES (AS OF SEPTEMBER 2014)

Metacognitive strategies and critical thinking

� Retention. What do I remember effectively, and why do I remember it?

� Development of new knowledge (from reading). What did I learn from this source?

� What background knowledge did this writer have to have in order to write this book?

� Ongoing emphasis on categorization (important in determining main idea, vocabulary study, analogies, figures of speech)

P: Will my focus on learning strategies have the best long-term pay-off?

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PART SEVEN. HOW I DO WHAT I DO: RECURRENT STEPS IN THE EDUCATIONAL THERAPIST’S CASE ANALYSIS AND REFLECTION PROCESS

� Analysis and interpretation of data

� Problem solving to determine appropriate goals and priorities in instruction

� Development of instruction, with consequent data gathering and further problem solving

� Confirmation of initial diagnosis through passage of time or modification if needed

� Collecting additional information and re-interpretation of data as needed

� Reformulating goals and adapting instruction as needed

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QUESTIONS TO PONDER AS WE DO OUR WORK

� How do I use my reflections and my notes to see patterns? What kinds of patterns are likely to emerge?

� Can I think of a case where first impressions were inadequate? How soon did I know?

� What is a language processing issue, and what is ADD? How do we disentangle complex presentations?

� How much can I compensate for perceived inadequacies in a school program? If I over-focus on compensation, might this produce a “hot house flower”?

� What are reliable indicators of progress over time?


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REFLECTIONS ON THE BENEFITS OF CUMULATIVE TIME AND EXPERIENCE IN THE EDUCATIONAL THERAPIST’S “LABORATORY”

� Educational therapy sessions are opportunities to use selected exercises and/or approaches over a variety of students to see what works well, with which students, and why.

� We can develop a rhythm in an educational therapy practice as we problem solve over time, with individual students and methods, and learn how best to teach each individual client.

� Part of our job is to observe the rhythm and flow of our own practices, to monitor and cultivate our own development as professionals.

� We need to periodically revisit what we did, even as seasoned ET’s, to recheck our data for patterns, to see what essential questions we have answered (Look at that!!)

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SUGGESTED RECORD KEEPING OPTIONS

� Summary of specific activities by session in the ongoing session folder

� Attendance log

� Lesson plan to log all proposed activities for the session

� The “session narrative” which records results of the lesson, areas needing further focus, areas of difficulty and success, ideas for future sessions, general impressions, new problems or insights, identification of trends and patterns.

� Additional folder for permanent records such as grade reports, data from allied professionals, etc.

� Folder for copies of relevant email communications

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BIBLIOGRAPHY

� Kaganoff, Ann. “Interest Inventory,” The Educational Therapist. Vol. 23, Number 1. Winter 2002, pp. 18-21.

� Kaganoff, Ann. “Study Skills and Homework Survey,” The Educational Therapist. Vol. 24, Number 2. Spring/Summer, 2003, pp. 15-18.

� See also a series of articles on assessment in The Educational Therapist 2013, 2014, by Marion Marshall and Dianne Matthaei

� Ungerleider, Dorothy. Educational Therapy in Action: Behind and Beyond the Office Door. Routledge: New York and London, 2011.

� Zaner_Bloser “Word Wisdom” teaching vocabulary in grade-level series. Some good free resources. Ex: Root and Meanings (Levels C-H). http://www.zaner-bloser.com/word-wisdom-program-resources

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