Education of Students with Dyslexia - Report Example

Dyslexia [Name Of Student] [Name Of Institution] DYSLEXIA INTRODUCTION Communication is the basis of all human interaction, and language is the tool that enables it to work. As a tool, language is represented as a series of symbols--auditory, visual, and kinesthetic--that allow the child entry into social and academic cultures. The degree to which a child develops those tools often determines the amount of success he or she achieves in both cultures. Spoken language becomes the earliest tool available to a child to permit entry and participation in the social culture. The child must learn the sounds, words, and word sequences of that language for communication to occur. Additionally, he or she must master the rhythm, intonation, and even the pauses that define the beginnings and endings of word groupings. Much of this mastery takes place prior to any thought of school. Upon entry into school, spoken language continues to be the tool for social communication, but now a significant shift takes place as an emphasis is placed on the use of language for academic learning. It is generally after this transition to school that problems in academic performance begin to suggest the presence of a learning disability. DEFINITION Dyslexia is a language learning disorder that results in deficits in reading, spelling, and, often, written language. Students who evidence dyslexia have adequate general cognitive ability but manifest considerable difficulty in learning to read via conventional instruction (Critchley, 1970). According to the National Joint Committee for Learning Disabilities, this disorder is "intrinsic to the individual and presumed to be due to central nervous system dysfunction" (Hammill, Leigh, McNutt, & Larsen, 1981, p. 336). Equally problematic is the use of multiple terms, custom-made to describe the child whose performance is compromised by the co-existence of a communication disorder and a learning disability. Such terminology, reported in the literature as "language learning disability," "specific language impairment," and "language-based learning disability," often suggests the existence of a single, specific disability rather than two distinctly identifiable disorders that co-occur. DISCUSSION In 1987, the National Joint Committee on Learning Disabilities (NJCLD) stated that learning disabilities is a general term which refers to a heterogeneous group of disorders manifested by significant difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning, mathematical, or of social skills. These disorders are intrinsic to the individual, presumed to be central nervous system dysfunction, and may occur across the life span. (Abrams, 1987, pp. 107-108) There are strong parallels between these definitions of learning disabilities and the most recent definition of language disorders advanced by the American Speech-Language-Hearing Association (1982), which states that "a language disorder is the impairment or deviant development of comprehension and/or of a spoken, written and/or other symbol system" (p. 938). Bloom and Lahey (1978) described language as a code whereby ideas about the world are represented through a conventional system of arbitrary signals used for communication. Their model included three fundamental components: (a) form (phonology, morphology, and syntax); (b) content (semantics); and (c) use (pragmatics). Their model is frequently used as a means of delineating the areas of normal and abnormal language development. Lahey (1988) applied this model of language to demonstrate an overlap between learning disabilities and language impairments in five areas. Both groups demonstrated the following: (1) difficulty with language form; (2) disruption of content; (3) impairment to use; (4) distortions in interactions among form, content, and use (meaning and conversational use were affected); and (5) separation of form, content, and use. CHARACTERISTICS Children with language and learning disabilities may experience difficulty in any one or all five components of a language system. These difficulties may be very apparent early on in life or may develop later and present as somewhat more subtle. Haynes et al. (1990) reported a significant number of common symptoms accorded to the older student that reflect difficulties in the semantic (e.g., word finding, limited vocabulary); syntactic/morphological (e.g., use of incorrect grammar, use of starters and stereotyped phrases); and pragmatic (e.g., use of redundancy, difficulty shifting style to fit social situations) components of language. If any of these characteristics interfere with educational performance, students are identified and programs are designed to meet their needs. As the research suggests, many young children identified with language difficulties are subsequently identified as having learning disabilities after they become school-age and when they meet with academic difficulties. Studies documenting the characteristics of younger children with language disorders found that they typically (a) have more difficulty with sentence repetition and completion; (b) have more difficulty with auxiliaries, modals, prepositions, conjunctions, and other grammatical markers; (c) use a small number of verb types; (d) have difficulty with pronoun case marking; (e) produce their first words later and acquire words more slowly; (f) produce fewer lexical categories per sentence; and (g) have problems processing acoustic signals (both speech and pure tones) when presented rapidly (Ingram, 1975; Rescoria, 1989; Rice & Bode, 1993; Snyder & Downey, 1991; Tallal, 1976; Watkins, Rice, & Moltz, 1993; Wiig, 1990). The child diagnosed with learning disabilities only is likely to have difficulty in academic settings, whereas the child with both language and learning disabilities will struggle in social situations as well. A practical way to delineate the two groups is to keep in mind that the child with learning disabilities is likely to struggle from 9 to 5, whereas the child with both a language and a learning disability will likely struggle around the clock. Implications for remedial instruction for students with dyslexia can be drawn from the preceding review. First, they need highly structured phonetic-instruction training with a heavy emphasis on the alphabetic system. To compensate for deficits in verbal working memory, they need drill and repetition. Also, multisensory presentations will help anchor verbal information through nonlanguage mental representations. Learning objectives should be highly sequential because the logic of language structures may escape these students. Comprehension and metacognitive processes need to be taught to assist these students in the conscious use of language rule systems to guide their reading and spelling. The OrtonGillingham instructional methods are based on these theoretic premises. ORTON-GILLINGHAM SCHOOLS Among the many private institutions known as Orton-Gillingham schools because their remedial programs are based on OG principles are the Gow School in South Wales, New York; the Kildonan School in Amenia, New York; and the LAB School in Washington, DC. These schools were established to provide alternative instruction to students with dyslexia. Although they vary in terms of specific programs, certain basic instructional components will be present at these schools and others like them. This paper will review the approach based on the Keystone Program [Cheatham & Lund, 1983) used at two schools in Richmond, Virginia--the Riverside School and the New Community School la college preparatory school for older students)--as an example of programs containing components of language remediation typical of OG. The Keystone Program was developed by Mary S. Cheatham and Ruth H. Lund to provide training in language fundamentals. This approach is diagnostic-prescriptive and individualized, and it advocates "strict adherence to multisensory applications of structures and practice" (Cheatham & Lund, 1983, p. xiii). Basic language patterns are taught directly, starting from sound-symbol association of consonants and vowels and proceeding to the six predictable syllable patterns found in about 85% of the English language. These patterns include closed syllable (not), vowel-consonant-vowel syllable (note), open syllable (no), R-controlled syllable (nor), consonant-le syllable (noble), and vowel-digraph syllable (digraph means the sounds combine to form a new sound, e.g., noise; Cheatham & Lund, 1983). Another category is used for special sounds that frequently appear in the language but do not follow the predictable patterns. Examples include to, do, and were. Instruction includes a great deal of practice in the identification of the patterns in nonsense and real words, with a constant emphasis on review incorporated into new lessons. A pattern of multisensory instruction is used that contains the following steps: 1. Teacher pronounces the syllable; 2. Student repeats the syllable, pronounces the vowel, and spells the syllable out loud; 3. Student writes the syllable, naming each letter as he or she writes it; 4. Student reads the syllable, penciling (using a pencil to track or underline while reading) below the syllable. MULTI-SENSORY APPROACHES In-depth discussion of these approaches can be found in Orton Dyslexia Society (1993) and Sheffield (1991). Alphabetic Phonics and the Dyslexia Training Program. In 1965, a remedial language-training program for students with dyslexia was begun in Dallas, Texas, at the Scottish Rite Hospital (Cox, 1984). Eventually, the Dyslexia Training Program was developed for teaching written language skills and the structures of written language, in addition to the Alphabetic Phonics program, which was based on original work by Gillingham. In 1985, Texas passed the "dyslexia laws," which mandated screening for dyslexia and outlined the type of training required for teachers of students with dyslexia. In 1992, the dyslexia programs at the Texas Scottish Rite Hospital were extended to include the Literacy Program, which has as its goal providing classroom remediation for secondary students and adults. The Herman Method. Many public schools use the Herman Method (Herman, 1975) as a remedial reading program. It differs from other OG programs in that it contains instructional strategies and techniques that are not typical. Examples are activities offering structured, simultaneous input to both the right and left cerebral hemispheres, techniques geared to clarity misperceptions, use of a metronome or similar pacing tool, and a wide variety of review activities, including ones using computers and special software programs. Lindamood-Bell Learning Process. Patricia Lindamood, Nanci Bell, and Phyllis Lindamood established centers that offer programs revolving around three basic sensory-cognitive processes vital to successful reading (Bell, 1991a, 1991b; Lindamood & Lindamood, 1975). The Language Comprehension and Thinking component strives to enable students to integrate pieces into gestalts (wholes) through visualization techniques. The Word Attack, Word Recognition, and Spelling component develops phonological awareness through the use of speech production to provide a basis for understanding language. Project Read. Victoria Greene and Mary Lee Enfield (Enfield, 1988) developed a program used in the Bloomington Public Schools in suburban Minneapolis. Their program incorporated the tenets of Orton-Gillingham into a mainstream language arts curriculum so that systematic, multisensory instruction could be made available in the general education classroom and taught by the general education teacher. The Slingerland Approach. The Slingerland Approach (Slingerland, 1976) utilizes simultaneous, multisensory processing and proceeds from the single unit to more complex units. Conceptual understanding rather than rote memorization is emphasized to facilitate learning transfer. The lessons include oral language development, phonics, encoding, decoding, spelling, written expression, and reading comprehension. The Spalding Method. "The Writing Road to Reading," as the Spalding method (Spalding, 1962) is known, integrates listening, reading, speaking, and writing. The program uses the Orton-Gillingham concept of the notebook for vocabulary development and spelling and also uses reading comprehension activities. This method has been effective in general education settings because of the ease of implementation within curricula. Wilson Language Training. The Wilson Reading System (Wilson, 1988) uses multisensory methods to teach the structure of English words so that students can master phono-logical processing for reading and spelling. The program is particularly geared for older students and uses controlled readers. Angling for Words. Angling for Words is a program designed for college preparatory students with dyslexia. It is geared to students at the fourth-grade level and above. ASSESSMENT Norm-Referenced Assessment Standardized or formal evaluation is necessary to document comparable scores and eligibility for educational and support services for the student with language and learning disabilities. In addition to having good reliability and validity, a formal assessment battery should evaluate functioning in the following areas: intelligence; problem solving; attention; concentration; memory; receptive and expressive vocabulary; listening comprehension; auditory processing; and academic ability, including performance using language (speaking, listening, reading, and writing). Testing Modifications In efforts to assess a student suspected of having language and learning disabilities, modifications to the testing situation may be needed. Some typical modifications include (a) changing the modality, or sensory channel, of the stimuli (e.g., auditory, visual); (b) presenting the stimuli through one modality and then in combination with several modalities (e.g., visual first, then auditory and visual); (c) presenting the stimulus several times before the student responds; (d) providing cues and prompts; and (e) providing multiple testing sessions (Ferguson, 1992). In addition, if the student has any additional deficits, such as attention-deficit disorder (ADD), then modifications may be necessary within each session. For example, it may be necessary to provide the student with a minute between subtests to walk around the room to release energy, or to allow the student to answer questions while sitting on the floor as opposed to at a table. Naturalistic Assessment Norm-referenced tests are necessary for determining eligibility for services and provide important data regarding overall language performance. However, there are many reasons for not relying on this type of assessment alone, particularly for this unique population. According to Launer (1994), norm-referenced tests (a) do not reflect actual communicative abilities, including pragmatics or language usage; (b) tap very specific skills with very specific methods; (c) produce anxiety and do not elicit realistic or optimal performance; (d) are not interactive, in that the student is in a position only to respond and not to initiate; (e) do not usually allow for creativity in responding or flexibility in scoring and interpretation; (f) do not reflect language and communication in the classroom; and (g) are frequently culturally biased and do not reflect the diversity of cultures in the clinical population. Task Analysis. Sohlberg and Mateer (1989) outlined four basic principles for designing and carrying out naturalistic assessments that are especially important for students with language and learning disabilities: 1. Identify the task parameters. The teacher needs to specify in behavioral terms what constitutes successful task completion before the student is asked to complete the task. Often, the clinician must actually complete the task herself or himself in order to identify the task components. 2. Evaluate environmental factors. The teacher needs to be familiar with the environment in which the task is being completed. In addition, the relationships among individuals present during the assessment are important, as these may directly affect student performance. If the student is in a familiar environment with familiar people (peers, teachers), performance may be enhanced. 3. Identify the measurement criteria. The criteria should include both quantitative and qualitative data that can be used for assessment, remediation, and measurement of progress over time. 4. Identify the levels of cuing and the use of compensatory strategies that are needed to complete the task. Initially, the student should not be given any cues. If he or she is unsuccessful, the task should be performed again, with the examiner providing a gradual increase in cuing in order to determine the amount required for the student to complete the task. Narrative Assessment. Narrative assessment is the product of a shift in emphasis in communication assessment, from the sentence level to the discourse level (Hutson-Nechkash, 1990). According to Roth (1986), narrative and conversational forms are two types of discourse that pose problems for students with language learning disabilities. (Roth, 1986; Roth & Spekman, 1986). Curriculum-Based Language Assessment (CBLA). CBLA is another form of naturalistic assessment. CBLA starts with identification of curricular contexts where language-related problems exist, and those contexts are used to develop assessments and interventions (Nelson, 1994). CBLA assesses the types of language skills and strategies the student with a learning disability possesses for processing the language of the curriculum, the types of resources he or she is using to meet the demands of the curriculum, the additional abilities and strategies the student might need to make the processing more effective and efficient, and changes that could be made in the curriculum or the way in which it is presented that would make it more accessible to the student (Nelson, 1994). SUGGESTED ASSESSMENT PROTOCOL A basic language assessment battery for the student with language and learning disabilities should consist of the following: (a) a comprehensive history and data review of work samples, previous assessments, and reports from teachers regarding functioning in the classroom; (b) a comprehensive language battery (see Table 1); (c) normed supplementary probes for language and auditory processing; (d) a curriculum-based language assessment; (e) descriptive data, including language samples and oral narratives; and (f) an assessment of performance under stress. All of these types of assessments have been outlined in the previous section. ENHANCING LANGUAGE ENVIRONMENTS FOR STUDENTS WITH DYSLEXIA- A CURRICULUM SUGGESTION The combination of collaborative planning, problem solving, effective teaching methods, and learning strategies is imperative in the education of students with language impairments and learning disabilities. Language learning environments that have been shown to be effective are those that provide opportunities for frequent interaction. That is, students are given many opportunities to talk and hear talk used for various purposes and in a variety of settings (Dudley-Marling & Searle, 1988). Denckla (1988) identified several principles for creating a language environment that is favorable for language learning. The first involves providing a physical setting that promotes talking. Instead of always structuring the classroom in rows of desks, providing larger tables for seating or setting aside an area in the classroom for students to gather for short periods of time to collaborate on schoolwork encourages students to use language. In addition, teachers can facilitate talk in the classroom by providing students with ideas that elicit talk. Specifically, teachers can provide concrete materials, such as pet animals, photographs, objects related to science projects, and so forth, that will promote opportunities to explain, share information, and ask questions. These materials and displays should be changed frequently to stimulate continued opportunity for talk. The second principle identifies the need for the teacher to provide opportunities for students to interact and use language while they learn. Meaningful discussions about learning activities in the classroom enable students to use discourse for the purpose of learning. The key task for the teacher is to provide opportunities for discussion that are related to the classroom learning activity. The third principle specifies that the teacher should provide opportunities for using language for a variety of purposes and with different audiences. Students need to be able to shift their language to accommodate different audiences. Opportunities to interact with younger or older students by sharing ideas, explaining the rules of a game, acting out a play, or collaborating on school projects are just some examples of ways to interact with different audiences. The final principle documents the need for teachers to respond effectively to student discourse. According to Denckla (1988), "children learn language best when they are directing the conversation to their own ends" (p. 141). To accomplish this, teachers should facilitate the conversation by following the student's initiations and keeping the conversation flowing. These four principles highlight several ways to create an effective classroom environment to promote language learning. For students with language impairments and learning disabilities, this type of naturalistic environment is the first step in providing effective intervention. After establishing an effective language environment, various techniques can be utilized to stimulate language production in the areas of form, content, and use. CURRICULUM IDEAS FOR TARGETING VOCABULARY FROM THE CLASSROOM FOR INTERVENTION Within the classroom environment, teachers need to target the instructional language, in addition to the language that is used in textbooks (Bashir & Scavuzzo, 1992). Vocabulary words should be identified that are relevant, functional, and individualized for each student. According to Hamersky (1993), the choice of vocabulary must take into consideration (a) the nature and severity of the student's communication deficit, (b) that student's particular interests and needs, and (c) the language needed for the home and school environments. Vocabulary words can be chosen from the academic curricula, various literature forms, classroom units, or functional "survival" words (Bashir & Scavuzzo, 1992). Content-Enhancement Strategies Visual format strategies are types of semantic organizers. They enable students to activate, retrieve, and build upon their existing knowledge. The use of visual formats can help students to (a) learn the meanings of and relationships among new words, (b) recognize words they already know, and (c) identify relationships among new and familiar words (Herman, 1995). Vocabulary that is relevant to the content area is introduced through one of the five visual format strategies, which include (1) the attribute web, (2) the Venn diagram, (3) the multiple-meaning tree, (4) a semantic continuum, and (5) the associated words format. Attribute Webs. Attribute webs are used to help students identify important attributes of a word (Herman, 1995). In this type of format, the keyword is written in the center of the web. The students generate different attributes of the word, which are written on extensions on the web. The characteristics are generated in a brainstorming session in which all responses are legitimate and recorded on the web. After the web is completed, students are asked to identify the attributes that best define the concept. The web can then be reorganized so that characteristics are grouped based on similarities. Once the second web is completed, students are encouraged to recognize that the meaning of one word can lead to many other words and ideas. The final outcome of this strategy is the generation of stories and role-playing of various situations. Venn Diagram. This type of strategy is used to help students visualize, understand, compare, and contrast the meanings and characteristics of two concepts. This activity can be completed by an individual student or a large group. In this format, students generate attributes of two concepts and write them in the appropriate circle. Similarities between the concepts are written in the overlapping portion of the circles (Herman, 1995). Multiple-Meaning Trees. For students with language impairments and learning disabilities, words with multiple meanings are frequently misinterpreted. A multiple-meaning tree can be used to help students visualize various meanings for content words. The concept is written in a rectangle depicting the center of the tree; the various meanings of the word are then written on branches that extend from the tree. Once the tree is completed, students should generate sentences for each meaning. A final activity would be to assist students in generating one sentence that contains all the meanings of the word (e.g., "Last evening, I tried to hit the flying bat with my baseball bat"). Semantic Continuum. A semantic continuum can be used to help students understand that groups of words that are related can be ranked according to changes in their meaning. To complete this activity, students must have an understanding of the specific attribute that is changing between the words. A key word or concept is identified, and students then generate words that relate to the key word. The concept and related words are then placed on a continuum. If this activity is too difficult, the teacher can place the target concept at one end of the continuum and ask students to identify its opposite at the other end. Students can then generate the necessary words to complete the activity. Associated Words Format. This format is used to highlight the interrelationships of word meanings. Students apply the target concept to each of nine categories: (a) similar meaning, (b) part/whole relationships, (c) class name, (d) class member, (e) opposite meaning, (f) where something exists, (g) when something occurs, (h) function, and (i) rhyming (Herman, 1995). The teacher may need to simplify the labels for students who have difficulty comprehending the categories (e.g., "Means the same" could be used in place of "Similar meaning," etc.). This task ultimately can help students to develop, enhance, and expand their vocabulary. NARRATIVE DISCOURSE ANALYSIS Students with learning disabilities often demonstrate problems in discourse (Roth, 1986; Roth, Spekman, & Fye, 1995). Hutson-Nechkash (1990) developed an intervention program that focuses on the remediation of oral narrative skills. The goals of this intervention involve: (a) exposure to literature; (b) development of the oral narrative, and (c) use of scaffolding techniques to aid in narrative construction. The program is divided into four parts: familiarization, practice, critiquing, and generalization. Familiarization. In this phase, the student is exposed to story-grammar elements contained in literature. The student should be able to recognize story elements and use that knowledge to reformulate stories presented orally. Suggested literature for this activity includes library books, children's magazines, taped storybooks, fairy tales, folktales, newspaper articles, poems, and language experience stories. Practice. The second phase of this program provides activities for building narrative skills. At the beginning of this phase, a high degree of structure or facilitation may be needed. This structure may take the form of providing picture cards for sequencing, story reformulation tasks, story frames, and story starters. Facilitation can be provided using scaffolding techniques. Supportive scaffolds are processes by which (a) control for task planning is gradually transferred from the adult to the student, (b) strategies are selected, (c) effectiveness is monitored, and (d) task outcomes are monitored. As the facilitator, the teacher can provide various techniques to scaffold for the student. These techniques include (1) cloze procedures, which are similar to fill-in-the-blank questions: "Could you pass me the salt and "; (2) preparatory prompts, which inform the student about an idea appropriate to talk about while giving the necessary cues for the student to perform: "You just had snack, but your friend might be hungry. You should ask him if he wants something to eat"; (3) gestures/pantomime: "Mary took her cup and she her milk" (adult makes the motion of moving the cupped hand to the mouth and mimes drinking); (4) relational terms, which prompt the student to add another event in a time sequence ("First we ...") and then talk about past events, the present, and so forth; (5) comprehension questions, whereby the student is asked to give information typical of his or her functioning: "What should the children do to get ready for bed?"; and (6) summarization questions, which prompt the student to recount a sequence of events: "Now it's your turn to tell the class what the fireman showed us today" (Damico, 1990; Miller, 1988). Critiquing. The third phase of the program involves critiquing and discussing oral narratives. In this phase, the student is first responsible for generating his or her own narrative. That narrative should serve the function of communicating and conveying information. Generalization. The final phase of this intervention program involves generalizing and condensing the oral narrative skills. IMPLICATIONS FOR THE FUTURE Issues of interest for future research include improving assessment and diagnostic approaches as well as focusing on intervention across the life span that emphasizes the integrity and wholeness of the individual diagnosed as learning disabled. Naturalistic assessments that evaluate language competence in all areas and include multiple sources of information provide a wealth of information about the functioning of the student with a learning disability. Future directions must continue to emphasize the importance of the development of diagnostic instrumentation that focuses on the student's unique needs and identifies areas of language intervention in the classroom. There is also a critical need to evaluate the effects of learning disabilities across the life span. 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