Assessment

One of the things that I hear quite often from parents is the following statement:

“When we inquired with the school about dyslexia, they told me, ‘dyslexia is a medical condition and that we need to go to a neurologist (or some other such physician) for the diagnosis.’”

Is that right?

Let’s  see.

The next time you go to your child’s neurologist (or other medical specialist such as a psychiatrist)  did they do the following:

• Determine whether there were phonological components of the language that were problematic?
• Have the child read a graded word list to determine adequacy of word identification skills?
• Listen to the child read a list of nonsense words to see if decoding was adequate?
• Assess oral reading fluency skills?
• Evaluate comprehension skills?
• Assess working memory and processing speed?
• Oh, and what about rapid object, letter and number naming? Were they assessed?
• Were different cognitive abilities evaluated?
• Was there a detailed review of school, developmental and family history?

Frankly, I don’t know too many neurologists in our area.  Do you? One I have recently come across is a private neurologist in dublin, but as you can guess, that is unfortunately too far for us to travel!

If they did have more in our area, it would probably take a minimum of three to four face hours with the kid, not to mention the time scoring, interpreting and writing up a summary.

Takeaway Point

If the school is telling you that you need a neurologist to determine whether your child has a learning disability such as dyslexia, you may want to respectfully disagree and remind them that there are probably not too many such neurologists that you know of doing an assessment that touches on all of these necessary components.

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Not in the South Jersey area? For a free 15 Minute Consultation, contact Dr. Selznick: email – contact@shutdownlearner.com.

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In contrast with kids who travel on a smoother road, on this site and in our books we are concerned with kids riding a rougher road.  These kids have a tough ride for all kinds of reasons.

Dyslexia evaluation and ADHD Assessment Tools

Here are some fundamental questions that can (and should) be asked of the kids on a rough ride, depending on the child’s age and stage:

• How are the child’s decoding skills? Regardless of age and stage, this is an essential question to consider.
• When presented with challenging words that don’t show up in the text all that often (think of words such as “porcupine,” “financial,” “institute”), can he/she read them smoothly and effortlessly?
• How does the child do when asked to follow sequences and basic directions?
• When given a passage roughly in the grade level of the child and asked to do a “cold read,” how does it sound?   Is it smooth and fluent or not?
• How is the child’s word knowledge or word awareness?
• How about understanding what is read? When the child reads different passages, how does he/she respond to factual questions? Inferential questions? Does he seem connected or disconnected to the material?
• Do you think your child shows the ability to sustain his/her mental effort or does is he falling off track and giving up easily?
• How does the child manage different types of problems where solutions are not readily apparent?
• What about math? How does he/she manage basic calculations? Word problems? Does the child seem confused?Does the child work through his/her challenge or give up easily?
• How connected is the child when interacting with others? How about his social skills?

Category is Less Important than Word Knowledge and other Fundamentals

Even though I find people to be very concerned about questions of category, such as does my child have dyslexia or ADHD, from my point of view the fundamental questions are examples of ones I am always asking when conducting an assessment.

The fundamental questions (the above are not an exhaustive list by the way) are ones that guide you as to what your next steps should be, what action you might want to take, what skill to develop.

Takeaway Point

I encourage you to be less concerned about a diagnostic category and more concerned about specific questions that lead to an action to take.

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Not in the South Jersey area? For a free 15 Minute Consultation, contact Dr. Selznick: email – contact@shutdownlearner.com.

To receive free newsletter and updates, go to: www.shutdownlearner.com.

In the last two blog posts we discussed some of the basics considerations with regards to assessment (Assessment Basics Part I Assessment Basics Part II). 

Among the points included:

• Longer, more complicated reports are not necessarily better.
• Assessment reports should be practical and understandable.
• Assessments provide a snapshot at a moment of time.
• Assessments identify whether there are “cracks in the foundation” that need to be understood.
• Ideally, you should be guided on what to next with your child.
• There should be commentary on the independent, instructional and frustration ranges

In this, the last post in the series, we focus on the issue of “the diagnosis” as a part of the assessment process.

People are rightfully interested in whether the assessment offers a diagnosis on learning disorders such as dyslexia, or other learning disabilities.

For me, as someone who is performing the assessments the challenge is what I call the “not-a-broken-bone” dilemma.

Common learning disorders all occur on a spectrum from very mild issues to more moderate and severe.  I know it is comforting to parents (mostly) to be told that the child does, in fact, have dyslexia (or ADHD), but understand that it is rarely a clear-cut, “yes-no” proposition.

Even after giving a broad battery of tests that are designed to offer such commentary, I still  find it challenging because there is no exact cut-off or place on the continuum that says “yes” or “no,” “has it,” “doesn’t have it.”
Ideally, with a good assessment there is a weighing of variables, a collective combination of both quantitative and qualitative data that adds up to provide a diagnostic profile leading a clinician to say with pretty good assurance that “Yes, your child has dyslexia,” for example.

This weighing of variables means there is clinical judgment involved.

Just yesterday, for example, I evaluated a college student who read somewhat inefficiently, who reported that she had trouble “focusing while reading,” yet in my judgement, after weighing a host of variables, I didn’t see her as “dyslexic.”  (I did see her as having a lot of anxiety, along with indicators of mild ADHD, along with her inefficient reading style.)

When the diagnosis is warranted giving the struggling a name helps to encapsulate it and feel more manageable and less overwhelming to parents and kids.  Once the name is given, there is typically an implied course of action.

Regardless, if your child has had an assessment, make sure that whether there is a formal “diagnosis” or not, you have a frank discussion with the clinician as to what he/she sees as the appropriate next steps.  Since there are many variables involved with these steps, the recommendations need to fit in with the reality of the child’s (family) situation.

Variables such as cost of treatment, availability of appropriate interventions in the child’s community, and the family’s scheduling logistics are all examples of to consider.

Takeaway Point

It’s not a broken bone.  Make sure you know the constellation of strengths and weaknesses identified in the assessment.  Maintain a “next-step thinking” mentality.

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Not in the South Jersey area? For a free 15 Minute Consultation, contact Dr. Selznick: email – contact@shutdownlearner.com.

To receive free Dyslexia Infographics and updates, go to: www.shutdownlearner.com.

Last week we talked about assessment and my view that there is often endless and unnecessary complication when it comes to assessing kids and their issues (Assessment Basics).  To help assess kids’ weaknesses in the classroom, there is now a easy grader system which does just that. Alongside this, individual feedback is given, where teachers can spend more time focusing on students individually. This week I want to elaborate on a couple of points.

As I noted, a good assessment provides a “snapshot” at a moment in time.  This snapshot should help you to understand a couple of basic questions:

• Does my child have a problem in the key areas assessed? (If so, how mild moderate and severe is it?)
• What is the nature of the problem? (e.g., is it and issue with reading fluency and decoding? Comprehension?  Anxiety? Avoidance?)
• What are my next best steps?

Those are basic, but very central questions to answer.

Since most of the concerns raised in special education and private childhood assessments involve the child’s struggling with reading, spelling and writing, I want to remind you (if you’ve been following my stuff over the years) of another important concept that is not discussed enough, but which is central in knowing what you should be doing with your child.

To make my point I will draw an analogy:

Twelve year old Avery is trying to build his upper body strength.  Currently, he can lift 10lb weights pretty easily.  At this weight he can do many repetitions without getting too winded.  In educational terms, the 10 lbs represents his “independent level,” the point where it is very easy for him and he can succeed without needing any support. When the gym teacher puts a few more pounds on the bar he notices that Avery is showing greater signs of struggling, but that increased weight represents that “sweet spot” of where Avery is moderately challenged, but not overwhelmed.   Effectively, this next increase of weights (say 15 lbs.) is Avery’s “instructional level,” the point where Avery can work pretty well but he may need some support.  When the gym teacher asks Avery to lift 20 lb. weights, he could lift the weights once, but is quickly overwhelmed.  That level was one of clear frustration to Avery.

When it comes to reading, it is less helpful to say the child is at a 2.4 or “Level M” (or whatever the letter is that corresponds to that grade equivalent).  It is much better to think in terms of ranges of instruction as described with Avery.

Commentary on these ranges should be a part of any psychoeducational assessment you are seeking.

Questions to ask your child’s clinician include, what range is the child fully comfortable and independent?  Where is he showing signs of difficulty, but reasonably capable (the instructional level)? At what point is the child fully overwhelmed (the frustration level)?

 Takeaway Point

Answering these questions on instructional ranges are central and fundamental to a good psychoeducational evaluation.  Make sure you are getting them answered.

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Not in the South Jersey area? For a free 15 Minute Consultation, contact Dr. Selznick: email – contact@shutdownlearner.com.

To receive free newsletter and updates, go to: www.shutdownlearner.com.

It’s that time of year.  That time when we sense the summer fading and the press of the fall (the school year).

Since so many of you have questions about what is involved with assessment, I am to lay it out for you with basic food for thought regarding the essential issues involved with assessment.  Please do not hesitate

Many people come to me with basic questions about assessment.  As is true with much of childhood, psychology and education, I find there is often unnecessary complication taking place with regard to assessment and many other related issues.

Parents will share previous assessments that have been completed.  Sometimes they are upward of 30-40 pages!  Much of it is uninterpretable or meaningless to the parent (yet looks impressive in its overall weight) and they feel bewildered by it all.

As I thumb through the reports, I often quietly (sometimes not too quietly) wonder if the parents’ basic questions  were even answered that led them to seek the assessment.

What got me thinking about this for this week’s blog was a mom’s who was interested in having her child assessed.  She emailed me a range of very in-depth questions of the cognitive and neuropsychological processes that she hoped might be revealed or commented on within the assessment.

I didn’t want to disappoint her, but this is what I said with regard to the questions raised:

Hi Mary Beth

In some ways the question you are asking about testing is over-complicating in terms of the goals that I have. In somewhat simplified terms, the psychoeducational assessment provides us with a “snapshot” in a moment of time as to where your child is in terms of her development in key areas of cognitive, academic and emotional functioning.  The “snapshot” is a great starting point in understanding your child’s strengths and weaknesses.

Beyond that, there are basic questions that are typically raised when conducting a psychoeducational assessment.  Are there any identifiable “cracks in the foundation” that need to be understood or addressed going forward?   What are your next best steps in terms of helping her if there are identifiable cracks? Is the school a good fit for her? (The parents were considering private school.)  Are there any other treatments or interventions that make sense given the assessment?

Assessment should be a practical vehicle, a springboard if you will, that can help guide you in terms of your child’s areas of need.  Ideally the generated report should be practical and fairly straight-forward in conveying the findings in as much jargon-free language as possible.  That is you should understand the report and what the numbers mean.  (“Hey, I see a score of 7 in Similarities in my child’s assessment.  What does that mean?  Is it good or bad?”)

In the next couple of weeks I will elaborate upon the fundamental questions and issues being raised in a psychoeducational assessment process to try and demystify it for you.

Takeaway Point

More complicated, more pages and more expensive is not necessarily better in an assessment for you child.

Stay focused on the basic questions.

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Not in the South Jersey area? For a free 15 Minute Consultation, contact Dr. Selznick: email – contact@shutdownlearner.com.

To receive free newsletter and updates, go to: www.shutdownlearner.com.

As part of an assessment I always ask kids to write their name and address.  Lately, I’ve been noticing a troubling trend. 

Increasingly, kids look at me blankly when it comes to the address part.  They don’t know where they live. 

Look, I understand that for kids with learning disabilities remembering how to spell certain street names can be challenging, but even when asked to tell where they live without writing it down, they are often confused.   

What I also have found out is they often don’t know what the word “address” means, so I rephrase it while they are looking at me – “You know, write down where you live.”  (The rephrased prompting often doesn’t help.  The blank stare remains.) 

I know.  

We are all relying on technology to a degree that may not be serving us very well.  There was a time when I probably knew over 25 phone numbers without looking them up in my address book (remember those?).  Now, I don’t even know my wife’s or kid’s telephone numbers, so I can’t be pointing a finger with too much superiority without a reminder of hypocrisy. 

For kids with learning problems, you may need to practice much more to obtain mastery for something like learning your address, but that’s the nature of things.  Patient practice and repetition usually helps; perhaps singing the address in some kind of song would also work. 

Along with knowing one’s address there are some other fundamental skills that are probably worth practicing and acquiring.  

For example, a friend of mine had her three sons mastering the skill of making their lunch by the age of 8.  Each night she had the three boys making their lunches.   Over time with practice and lots of parental patience, they got pretty good at it.

Practicing concepts of time and money are pretty essential and also  tough for kids with learning issues.  You will need extra patience to reach some level of mastery.   

Dare I say learning to do the laundry and making one’s bed at a young age are probably pretty good skills to acquire.  I know that my own parents never held my “feet to fire” in mastering these skills (among many others), and looking back on it I think it was a mistake. 

So, as we’re calling out to Siri, Alexa or “Ok Google,” and our kids are watching us in our own screen-technology obsessions, you might want to pause and consider what’s being gained, but also what’s being lost. 

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For a free 15 Minute Consultation, contact Dr. Selznick: email – contact@shutdownlearner.com.

To receive free Dyslexia Infographics and updates, go to: www.shutdownlearner.com.

When talking to parents about their children I am continually using metaphors, imagery that can help parents to better understand their children.

One of  the favorite images I use refers to  the “pie cart” of childhood.  How we divide up the pie is the concern that I try to convey to parents.

Far too often, I find the pie doesn’t get divided at all and parents are given a label, a one-factor explanation as to what is going on with the child.   One-factor explanations are used to explain issues that are rarely simple or straight forward.

Nearly every day at least once I will hear things like,  “He was diagnosed with ADHD.”  (“Really?  That’s it,” I think to myself.   “The whole pie chart is one large piece called ADHD?  There are no other factors or variables that are contributing to the child’s struggles.”)

One-factor explanations – labeling kids

Here’s a one-factor pie chart explanation.

Usually, with one-factor explanations, you get one-factor solutions, such as putting the child on medication.

I almost always find myself getting my back up when I hear this common one-factor, labeling of children.  It’s almost always more complex than that.

For example, the problem may not just be in the child’s head, it could be an outside the head issue.  Isn’t it possible that some of the reason the child is off task is due to the fact that he is given work that is boring and above his capacity level?

Who likes to be doing boring work that is too hard?

Two-factor explanations

Well that would at least divide up the pie into two pieces:

Three-factor explanations

Maybe the child is also prone to feeling anxious, giving us  a pie divided into thirds.

Complex Pie Chart for Understanding Children’s Behavior

Or in addition to being anxious while getting  boring and overly challenging work, and signs of ADHD,  he also has some reading fluency and decoding issues giving us an even more complex and new pie chart to consider.

And, what about, the child’s family and the fact that the parents have been arguing a lot lately?  Might that be in the pie chart?

Well, you get the idea.

As a general rule, I would encourage you to resist simple, one-factor labeling explanations. Ask yourself  (and the professional assessing your child) what else is in the pie chart?

Keep in mind, though, that you need to understand that the pieces are rarely as equal as the ones shown above.  Kids are not pizza pies with equal slices.

For example, here’s an 8 year old kid’s pie chart I saw recently who had significant reading issues.  The reading issues were the predominant variable, even though there were other factors of importance:

As the TV commercial says, “What’s in your wallet?”

“What’s in your child’s pie chart?”

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For a free 15 Minute Consultation, contact Dr. Selznick: email – contact@shutdownlearner.com.

To receive free Dyslexia Infographics and updates, go to: www.shutdownlearner.com.

Too often parents feel bewildered by the array of options that are presented to them about their struggling child.

Getting clear on what you are targeting and why is essential.  Common sense needs to prevail.

Eight year old Jackie, a spunky third grader, struggled with reading, spelling and writing.  Today when she read a third grade level story out loud to me , the passage she was to  read stated, “I saw the signal on the shore…”  Jackie read it as, “I saw the seagull on the shore…”

When I reviewed what had been done with Jackie to date, her mom sounded bewildered.

“When Jackie was five she could barely write her name and her letter formation was very poor.  It was recommended that we see an OT (occupational therapist) who identified “sensory issues” and suggested we get Interactive Metronome Therapy. We did that for a while, but Jackie struggled in first grade.  Then we heard about a person who administered special colored lenses for reading and someone else who suggested a different type of vision treatment. After that, an audiologist found central auditory processing disorder and recommended that we go to her office for a year of computer treatment to address the “auditory” issues. Another therapist felt anxiety was the issue and  suggested we treat that. Then we saw a neurologist who wanted to put her on medication for ADHD.   I am bewildered.  Everyone’s saying something different about what she need – she’s so far behind in reading, spelling and writing – I just don’t know what to do.”

“Has anyone suggested that they teach Jackie to read,” I asked.

“Not really,” she said. “I keep getting all of these treatment recommendations, but very few have said anything that makes sense regarding reading. I am really feeling overwhelmed by all of this and don’t know what direction to go.”

It was clear that Jackie needed sensible reading remediation, yet all of the professionals in the mix were recommending side-treatments that were not going to address her reading issues.

If reading is the primary concern, then that should be the target of treatment/remediation.  If it is anxiety, then target that.

To hit a tennis ball better, you wouldn’t go for swimming lessons.

Professionals will see things from the window of their own specialty (e.g., auditory, visual, medical). The narrower the window, the narrower the recommendation.

Get clear on what needs remediating and why you are doing it before you commit a significant amount of time and money.

Takeaway Point

Be certain that there is a match between your areas of concern andthe program being recommended. Does the program pass the commonsense test?

If it does not, you may want to think twice before proceeding.

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For a free 15 Minute Consultation, contact Dr. Selznick: email – contact@shutdownlearner.com.

To receive free Dyslexia Infographics and updates, go to: www.shutdownlearner.com.