effects of individualised learning procedures on children with specific learning disabilities

Develop. Med. Child Neurol. 1974,16, 507-512

Effects of Individualised Learning Procedures on Children with Specific Learning Disabilities

Anthony D’Annunzio Doreen R. Steg

Introduction Recent attempts to help children with

learning disabilities have been concerned mainly with detection and remediation during the pre-school years. These remedial efforts have generally been of two varieties-‘more of the same’ or the ‘shot- gun’ approach. In the first, there is intensification of activities which pre- school youngsters normally experience (story-telling, trips, informal learning sessions) in an effort to compensate for the children’s deficiencies. In the second. learning-disabled children are exposed to a wide range of remedial procedures which have been used successfully with older children. Neither approach appears to have been successful, as both tend to be too amorphous and to neglect the learner’s specific inadequacies.

The present study was made to determine the efficacy of an approach which stresses differential diagnosis, a description of each child’s abilities and deficits for learning, followed by prescriptive remedial procedures.

Method Twelve children of average intelligence

(four of whom were girls and half of whom were Negroes) between the ages of four and six years were selected from the Drexel

University’s Early Childhood Center. All were selected because of pronounced deficits in auditory or visual perception. Visual perception was assessed by the Frostig Developmental Test for Visual Perception (Frostig et al. 1963). Auditory perception was assessed by the average age-norms of the sub-tests on the Illinois Test of Psycholinguistic Abilities (Kirk et al. 1968)-auditory sequencing, auditory closure, and sound blending. Other studies indicate that disabled readers and pre- school children with auditory deficits obtain significantly lower scores on one or a combination of these sub-tests (Kass 1966, Hirshoren 1969).

Each of the 12 children was matched with a child in a control group (from a nursery school in the same community) in terms of the following factors: chronolo- gical age (within three months); IQ (within eight points); visual perceptual quotient (within four points); and auditory perception (within three months).

The experimental group (Group I) received 30 hours of instructional time over a seven-month period (approximately 20 minutes during each school day). The control group (Group 11) received at least as muchinstructional time, but the remedial programs used in the nursery school were based on the‘more of the same’ or the

Department of Human Behavior and Development, Drexel University, Philadelphia, Pa. 19104.

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DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY. 1974, 16

‘shot-gun’ approaches. By selecting the control group from this particular center, it was hoped that the conditions of the control group would provide the same attentional and motivational components as were encountered by the treatment group, apart from the specific training techniques to be evaluated. In addition to ‘formal’ instruction, both groups followed a routine schedule of nursery-school activities.

The 12 treatment children (Group 1) were divided into two equal groups. Group la comprised the youngsters who obtained the lowest scores on the test of visual perception, and Group Ib consisted of the children who obtained the lowest scores in auditory perception. The instructional procedures differed for each sub-group. With Group la, instruction began with programs to improve their visual deficits: each child had a diagnostic profile or ‘learning print’ which included an indication of which specific visual deficiency or cluster of deficiencies was to be remedied first. For example, one child began with programs to develop general form and configuration (such as matching pictures to outline drawings and super- imposing pre-letter forms), while another may have been introduced to letter orienta- tion or visual sequencing. In time, each child was introduced to programs for developing speed of visual discrimination and, finally, to whole words.

The same format was followed for Group Ib, except that the instructional procedures were concerned with auditory perception. For example, one youngster would begin with exercises to develop such comparatively simple abilities as repeating words or imitating sound and rhythm patterns. Eventually the child would be initiated into comparatively more difficult tasks such as blending syllables into words or using visual symbols to improve auditory discrimination and analysis. A teacher,

with guidance and assistance from super- visors and university staff, practised a circular relationship between evaluation and teaching: she used the feed-back of the child’s responses to determine her next step by observing how the child responded to a series of situations and noting where he succeeded and where he failed.

It can be seen that each child was receiving instruction at a different point along the perceptual developmental con- tinuum.

Approximately 80 per cent of the words and stories used for instruction were drawn from ‘experience’ stories which each child related to college students. The child’s story was included in a weekly ‘newspaper’ devoted to pictures of the children’s activities as well as to the stories they related. When a child was eventually introduced to reading, his own experience stories provided excellent material for directed reading activities : since the words in his stories were by then familiar to him, his initial introduction to reading was always successful.

It was found, however, that our approach did not go far enough. The procedures were designed to correct the child’s deficits, but simply remedying deficits is a limited concept of instruction. Although a major purpose of this experiment was to improve the children’s deficiencies, it cannot be assumed that if the child’s auditory ability (e.g. sequencing) is raised the child will be capable of generalizing this skill to other areas of function. Furthermore, many children cannot tolerate too much stimulation through their weak modality. Indeed, using the approach of remedying a child’s deficits alone may only ensure that introduction to reading needs to be post- poned until these deficits are corrected, which for some children may mean waiting until second or third grade. It is also neces- sary to continue teaching to a child’s abilities: for example, a child with visual

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ANTHONY D’ANNUNZIO DOREEN R. STEG

deficits in perception will have difficulty in retaining visual images of every word and will need to acquire a systematic means of identifying words; however, if the child’s auditory perception is good he can be taught to identify words phonetically and syllabically.

We therefore spent one-quarter of the instruction time in teaching to the child’s perceptual capacities. For Group Ia, at least one of every four training sessions emphasized the development of the child’s stronger modality. This was also the case with Group Ib, though the modality was different. Teaching only to the child’s modality of strength, however, may allow his capacity to become unduly functional. Such a child may, for example, need to learn most new words by rote if his visual modality became unduly functional at the expense of his auditory modality.

An example of the instructional procedures followed with one child may help to clarify our method.

Ted’s ‘learning print’ indicated a pronounced auditory deficiency. Although five years old, his ITPA auditory scores averaged at the three-year level; his most decided weaknesses were auditory closure and sound blending. However, his Frostig perform- ance was somewhat above that expected for his age. A college student had developed a good relationship with Ted and tape- recorded a number of stories he had related. At least three times each week his teacher and teacher-assistants provided 20- minute small-group or individual remedial instruction designed to strengthen the auditory modality. Auditory closure lessons, for example, were developed. A tape- recorder was particularly useful : Ted was required to identify words from his experience stories with syllables omitted (L-acaroni’ for macaroni and ‘-an-a - - a d for Santa Claus). Similar lessons were developed to remedy his inadequate sound- blending skills. Ted also had a weekly

session designed to enhance his comparatively well-developed visual modality. It was apparent that he could recognize words presented as wholes, especially when they occurred in his own experience stories. One of his stories was typed out and he was asked to indicate a particular word he would like to ‘learn’. He was taught to look at the word until he thought he could recognize it among a group of words. At the next session, groups of words he had learned were presented tachistopically to determine whether he had retained the ‘learned’ word. Eventually, groups of ‘learned’ words were made into sentences for Ted to read.

Findings Since the treatment children had been

paired with controls, the desired comparison between the results of the two forms of remedial teaching was found directly from the differences between pairs of children. The simplest approach was to treat the individual changes as if they were single measurements and then determine paired change values (Edwards 1954, Guilford 1956).

Table I shows that the mean pretreat- ment scores on the Frostig test for Groups Ia and IIa were below the 25th centile. After remedial treatment, Group Ia moved close to the 40th percentile. The Frostig quotients for Groups Ib and IIb were above the second quartile both before and after remedial treatment, since these children had good visual perception but had deficits in auditory perception.

The mean age of all the children was 44 months. As shown in Table I, the age- scores for auditory perception tests were approximately 89 months below chrono- logical-age expectation for Groups Ib and IIb. After remedial teaching, Group Ib had gained an average of eight months (an expected increase since the period of treatment was eight months), but Group IIb

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DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY. 1974, 16

Treatment group

Test Group la Group Ib -

Pre Post Pre Post

PPVQ * 98 101 98 100 Frostigt 88 95 104 107 ITPA

(months) 45 52 36 44

TABLE I Test means and mean age-scores from three ITPA sub-tests

Conirol group

Group Ila Group Ilb

Pre Post Pre Post

98 100 97 99 88 89 105 106

47 50 35 37

t test

t = 7.2 p < .01 t = 6 .5 p < .01 t = 2.1 p > .05 t = 2.1 p > ,05

_ _

*Peabody Picture Vocabulary Quotient tFrostig Perceptual Quotient

averaged only a two-month increase. Table I1 shows that Group Ia made

significantly greater improvement in visual perception, while Group Ib did likewise in auditory perception. The improvement in auditory perception in Group Ia, although not statistically significant, approached this criterion when compared with Group ITa. N o significant differences were revealed between Groups Ib and IIb on Frostig evaluation.

We had great difficulty in obtaining a sufficiently large number of children from the same socio-economic groups who had a large discrepancy between their Frostig scores and ITPA scores, hence our comparatively small population sample. Neverthe- less. the data strongly suggest that better results were obtained with a specifically- planned, corrective teaching approach than

TABLE I1 Comparison of results in two groups receivin::

remedial teaching programs

Test

Fros tig * ITPAf

Frostig

ITPA

.._____ Group F

l a I’ IIa

Ib v I ib

Ib I’ IIb

Ia i’ Ila

~~

*Frostig Developmental Test of Visual Perceptioii -/-Three lTPA Auditory Perception Tests

with typical nursery-class early instructional programs.

Discussion The findings in this study suggest that an

early instructional program which em- phasizes for each child a differential diagnosis, the development of a ‘learning print’, followed by suitable prescriptive procedures, is superior to the routine type of pre-reading instruction offered by a representative nursery school. Since both populations in this study were receiving readiness and pre-reading programs in small-group or one-to-one relationships, it is doubtful that the differing results were due to the ‘Hawthorne effect’.

Although every child entering the Early Childhood Center receives a complete diagnostic work-up, it is generally not advisable to pay too close attention to these findings for planning the child’s educational program. What is more important is the point of view and degree of sophistica- tion among the instructors which concen- trate on continual assessment of the child’s learning abilities and disabilities. Careful scrutiny of the way the child responds to the presentation of stimuli to specific modalities will allow clinical inferences to be made about the child’s operational strengths and weaknesses. This is not to deny that learning is basically an integrative procedure, depending heavily upon recip-

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ANTHONY D’ANNUNZIQ DOREEN a. STEG

rocal functioning of the entire learning system; indeed, that is why sophisticated instructor observation and knowledge about learning strategies are so important. Educational intervention can then be planned to teach to a child’s capacities for learning, while simultaneously remedying his weakness in a deficient modality.

Methods of teaching which ignore the perceptual strengths and deficits of youngsters, or are translated into a curriculum for all children (e.g. the exclusive use of perceptuo-motor training for all children in a certain age-bracket) are likely to magnify the difficulties some children have in developing reading skills. This is particularly important for children who are learning-disadvantaged.

Table I indicates that Groups IIa and

IIb maintained their developmental progress in auditory perception and visual perception respectively. This could indicate that if children have ability in a specific modality, they tend to retain it with the moderate or incidental stimulation occurr- ing in their nursery school. However, this was not the case in Groups IIa and IIb in terms of progress in their deficient modalities-visual perception and auditory perception respectively.

In conclusion, this study suggests that in our group of children with pronounced perceptual deficiencies, the most vital remedial step was the institution of corrective teaching procedures which took into account each child’s abilities and deficits in learning.

SUMMARY Twelve children between four and six years of age, with average intelligence but with

pronounced deficits in auditory or visual perception, were each given 30 hours remedial treatment for their learning disabilities over a period of seven months. The treatment consisted of differential diagnosis, the development of a program specific to each child’s learning deficit, and the use of remedial procedures specific to the deficit. A control group of 12 children received the same amount of remedial treatment, but based on the typical nursery-class instructional programs.

The findings suggest that better results are obtained when remedial procedures for learning disabilities are planned specifically to overcome the individual child’s deficit. Such procedures should also take into account the child’s abilities, as well as his disabilities.

R ~ S U M B E f s s de prockdks d’apprentissage individualist% sur des enfants

prksentant des troubles spe‘cifiques des apprentissages Douze enfants de quatre A six ans, d’intelligence moyenne mais avec des dtficits prononcCs

des perceptions auditives et visuelles ont reGu chacun trente heures de rttducation sur une pCriode de sept mois pour leurs troubles des apprentissages. Le traitement a consist6 en un diagnostic diffirentiel, la mise en place d’un programme sptcifique pour le trouble partic- ulier de chaque enfant et I’emploi de thtrapeutiques sptcifiques au dtficit. Un groupe contrale de douze enfants rewt la mCme quantitt de rttducation mais basCe sur les programmes &instruction d’une classe maternelle typique.

Les conclusions suggtrent que de meilleurs rtsultats sont obtenus quand la rCCducation des troubles d’apprentissage est Ctablie sptcifiquement pour surmonter le dCficit de chaque enfant. De tels programmes tiennent compte autant des possibilitts des enfants que de leurs difficultts.

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DEVELOPMENTAL MEDICINE A N D C H I L D NEUROLOGY. 1974, 16

ZUSAMMENFASSUNG Der Effekt individuell abgestimniter Lehrmethoden auf Kinder mit

spezijischen Lernschwachen 12 Kinder zwischen 4 und 6 Jahren niit durchschnittlicher Intelligenz aber ausgepragten

Storungen der auditiven und visuellen Wahrnehmung bekamen in dem Zeitraum von 7 Monaten je 30 Behandlungsstunden zur Behebung ihrer Lernischwache. Die Behandlung bstand in der Erhebung der Differentialdiagnose, der Entwicklung eines fur die Lern- schwache eines jeden Kindes spezifischen Programmes und der Anwendung einer dafur spezifischen Heilbehandlung. Eine Kontrollgruppe mit 12 Kindern erhielt die gleiche Anzahl von Behandlungsstunden, die jedoch nach einem fur die Vorschulklassen typischen Unterrichtsprogramm abgehalten wurden.

Die Befunde sprechen dafur, da13 man bessere Ergebnisse erzielt, wenn die Behandlungs- methoden der Lernschwachen fur jedes Kind neu ausgewahlt werden, uni gezielt die indi- viduelle Schwache eines Kindes zu beheben. Die Behandlungsmethoden sollten sowohl die Fahigkeiten wie die Schwachen eines Kindes berucksichtigeri.

RESU MEN Efectos de mktodos indiridualizados dp aprentlimje e : ~ nirlos con dificultades

esppcificas en el aprendizaje A 12 niiios de 4 a 6 aiios de edad, con inteligencia del ttrmino medio, per0 con pronun-

ciados deficits en la percepcion auditiva o visual, se les procuro 30 horas a cada uno de tratamiento por su dificultad en el aprendizaje, durante un periodo de 7 meses. El tratamiento consistio en diagnostic0 diferencial, el desarrollo de un programa especifico para el deficit de aprendizaje de cada niiio y la utilizacion de mktodos especificos para el dkficit. Un grupo control de 12 niiios, recikieron la misma cantidad de tratamiento, pero este se bas6 en 10s tipicos programas de instruccion de una guarderia o nursery.

Los haltazgos sugieren que se obtienen mcjores resultados cuando se planifican especifica- mente 10s mttodos de aprendizaje, con el objeto de cubrir el deficit individual de cada niiio. Tales procedimientos deben tener en cuenta no s610 las dificultades, sino tambiin las habilidades de cada niiio.

REFERENCES Edwards, A. (1954) Statistical Methods for the Brhavioral Sciencis. New York: Rinehart. p. 219. Frostig, M., Lefever, D., Whittlesey, J . , Maslow, P. (1963) The Marianne Frostig Developmental Test o/’

Guilford, J. P. (1957) Fundaniental Statistics in Psychology and Ei9ucation. New York: McGraw-Hill. p. 198. Hirshoren, A. (1969) ‘A comparison of the predictive validity of the revised Stanford-Binet Intelligence

Kass, C. E. (1966) ‘Psycholinguistic disabilities of children with reading problems.’ Exceptional Children, 32,

Kirk . S A. McCarthy, J . J., Kirk, W. D. (1968) Illinois Test of Psycholingui.ytic Abilities, Revised Edition.

Vi.waf Perception, 1963 Standurdi.sation. Palo Alto. : Calif. Consulting Psychologists Press.

Scale and the Illinois Test of Psycholinguistic Abilities.’ Exceptional Children, 35,7.

533.

Urbana, Ill.: University of Illinois Press.

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effects of individualised learning procedures on children with specific learning disabilities

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