Assessing and Differentiating Reading Disorders
Linda J. Lombardino, Ph.D.
Professor of Speech-Language Pathology
School of Special Education, School Psychology and Early Childhood Studies
Presentation at The Ohio State University
Department of Speech and Hearing Science
January 26, 2012
Model for Assessing Reading and Writing
ASSESSING AND DIFFERENTIATING READING & WRITING DISORDERS: A MULTIDIMENSIONAL MODEL is designed for professionals who evaluate and treat children with reading and writing disorders. It provides a framework for differentiating among various types of reading and writing disorders in order to assist the practitioner in establishing a differential diagnosis. This text introduces a multidimensional model that can be used to create profiles of a learner's strengths and weaknesses using 10 skill domains associated with reading and writing. Samples profiles for preschool and school-age children include assessment protocols, diagnostic reports, and treatment plans. A synopsis of relevant literature related to the relationships between spoken and written language, and the best predictors of reading achievement, along with a chapter devoted to counseling and intervention round out the text to provide a complete roadmap for evaluating the weaknesses and strengths in children who have reading and writing difficulties.
Language Knowledge
Word retrieval
Discourse
Syntax
Morphological Knowledge
Vocabulary
Environmental Factors
Neurological Factors
Grapho-phonemic Integration “Alphabet principle”
Word level reading
Word level spelling
Text level writing
Text level reading
Phonological Knowledge
Print Knowledge
READING ACHIEVEMENT
3 Multidimensional Model for Assessing Reading and Writing (MARwR)
Spoken Language
Vocabulary Understanding of words and word meanings in both spoken and written language
Word retrieval Accessing pronunciations of words or sound patterns stored in memory
Morphological awareness
Understanding that morphemic units exist in words and contribute to the meaning of the word
Syntactic knowledge Understanding how to use grammatical rules and to adhere to word order, morphological
markers, and other syntactic constraints of one’s language
Discourse skills Understanding causal connections and inferences in texts
Print Knowledge
Print awareness Knowledge of book conventions, concept of word in print, and print mechanics
Letter knowledge Knowledge of letter names and ability to write letters that represent letter names
Word awareness Knowledge that words can be segmented into separate units that represent individual spoken
words
Phonological Knowledge
Phonological
awareness
Awareness that the stream of speech can be broken down into smaller units
Grapho-phonemic Integration
Phonics knowledge Mapping phonemes (sounds) onto graphemes (letters)
Invented spelling Knowledge that sounds are represented by letters in some consistent way and use of this
knowledge to create spellings prior to conventional instruction
Skills Targeted in MARwR
[
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Word-Level Reading and Spelling
Decoding Segmenting letters in words into corresponding sounds, then blending sounds to
create real words or nonsense words
Word recognition Recognizing familiar words in print (sight-word recognition) such that sight of
spelling patterns results in immediate word recognition
Spelling Remembering spelling for sound units (e.g., -ight sounds
like /ai/) and knowledge of rules that determine word pronunciations (e.g., silent e
dictates the pronunciation of site)
Text-Level Reading
Reading comprehension Understanding the meaning of information in print
Reading fluency Reading words and text accurately and effortlessly
Text-Level Writing
Mechanics & conventions Handwriting and punctuation
Composition Planning, translating, and reviewing written text
5
Summary Sheet for Weaknesses and Strengths
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Preschool – First Grade
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At Risk Classifications for PK – First Grade Children Profile 1: Mixed Language and
Emergent Literacy Deficit
Mild to severely depressed language production and/or
comprehension
Difficulty in one or more phonological processes
Low normal to above average nonverbal intelligence
Absence of primary visual, auditory or motor disabilities
Profile 2: Emergent Literacy
Deficit
Normal language with or without a history of articulation difficulties
Difficulty with emergent literacy skills especially letter knowledge
and sound-letter associations
Low normal to above average nonverbal intelligence
Absence of primary visual, auditory or motor disabilities
Profile 3: Environmental
Disadvantage Deficit
Overall depressed pre-academic skills with or without previous
identification of a language delay or disorder
History of diminished opportunities for exposure to language and to
literacy concepts at home and/or in school
Low normal to above average nonverbal intelligence
Absence of primary visual, auditory or motor disabilities
Classifications
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Profile 1
Mild to moderate
mixed spoken
language & emergent
literacy deficit
Profile 2
Emergent literacy
deficit
Profile 3 *
Environmental
disadvantage deficit
Spoken language
knowledge _ + -/+
Phonological
knowledge -/+ -/+ -/+
Grapheme-
Phoneme
knowledge
-/+ _ -/+
Early Literacy Classifications (4-7 years)
Brittany
Profile 1
Severe spoken language & emergent literacy deficit
10
Amanda
Profile 1
Moderate mixed language and literacy
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Carlos
Profile 2
Emergent literacy Deficit
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First Grade & Beyond
13
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Profile Type Spoken Language characteristics Reading and Writing Characteristics
Profile 4: Mixed
Spoken and Written
Language Disorder
Exhibits depressed oral language
abilities in one or more domains of
language (e.g., semantic, syntax,
pragmatics), however, deficits in
phonological processing
(awareness, memory, rapid) are
often mild and sometimes do not
occur
Typically has a history of early
language impairment
Often shows deficits in production
of oral language narratives and
other forms of oral discourse
Often shows deficits in use of
morphological and syntactic forms
Can exhibit relatively good word
recognition and reading fluency, and
spelling
Exhibits depressed reading comprehension
Exhibits depressed writing composition in
terms of story grammar and other structural
elements of discourse
Morpho-syntactic and semantic errors are
often observed in written composition
Classifications for End of First Grade and Beyond
Gail (9 years) Profile 4
Mixed language and literacy
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Gail (9 years)
Profile 4
Mixed language and literacy deficits
16
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Profile 5:
Dyslexia
Deficits in phonological and orthographic
coding along with a lack of fluency in reading
Depressed ability to remember the precise oral
pronunciations of words learned, particularly
when they consist of multisyllabic and
complex constructions.
Relatively frequent history of articulation
therapy
Low average or above language production
and comprehension skills depending on the
severity of the word reading deficit
Listening comprehension exceeds reading
comprehension although sometimes holding
lengthy oral directions in memory is difficult
Handwriting varies from good to very poor
Writing conventions, such as punctuation and
capitalization are often ignored or misused.
Depressed phonological decoding of
nonwords, word reading, spelling, and
reading fluency
Listening comprehension exceeds word
reading and reading fluency
Spelling is always impaired and retention
of word spelling is very difficult
Writing mechanics including punctuation
conventions are typically poor.
Morph-syntactic deficits may be apparent
in written language
Handwriting can range from good to
illegible but is typically of poor quality
Evan (10 years)
Profile 5
Dyslexia
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Evan (10 years)
Profile 5
Dyslexia
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Profile 6: Reading
Comprehension
Disorder
Typically unidentified with
learning difficulties until 4th
grade and beyond.
Average to strong phonological
decoding and word recognition
Relatively weak language
comprehension skills at the word
and discourse levels
Weaknesses in telling well
structured and integrated stories
orally and in writing
Variable performance on tasks of
working memory
Word level reading, decoding
and spelling are all superior to
reading comprehension
Depressed reading
comprehension skills,
particularly beyond a 3rd-4th grade
reading level
Harry (14 years) Profile 6
Reading Comprehension Deficit
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Harry (14 years) Profile 6
Reading Comprehension
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Profile 4: Dyslexia Profile 5 : Mixed Spoken
Language and Literacy
Profile 6:
Comprehension Deficit
Listening
comprehension
Language concepts
+ _ -/+
Word-level reading _ -/+
+
Reading fluency
_ -/+ +
Reading
Comprehension
+
_
_
Diagnostic Classifications
Examples of Treatment Recommendations
Dyslexia Orton-Gillingham based approach to reading. Lexercise (http://www.lexercise.com/), an advanced Web-based treatment program for children who have dyslexia or other language-based learning disabilities Touchmath program (http://www.epsbooks.com) Ginger software (http://www.gingersoftware.com)
Mixed Spoken Language and Literacy Language intervention that targets words meanings in the context of listening comprehension activities Reading intervention that targets strengthening her reading fluency and improving knowledge of word meanings Language Tune-Up Kit at Home Reading Software. Quick Reads: A Research-Based Fluency Program Touchmath program (http://www.epsbooks.com)
Comprehension Deficit Strategies for achieving reading comprehension for narrative and expository texts Semantic webbing strategies Comprehension monitoring strategies Making Connections: Explicit Instruction for Comprehension Skills and Strategies
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In-take Forms
• Appendix 3-1. Caregiver/teacher questionnaire for preschool-early first
grade children
• Appendix 3-2. Caregiver/teacher questionnaire for school age children at the end of 1st grade and beyond
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