understanding dyslexia an introduction to effective intervention

Understanding Dyslexia An Introduction to Effective Intervention

Thomas J. Diebold, Ph.D.

Senior Consultant for Training and Development

Educational Service Center of Central Ohio

2080 Citygate Drive

Columbus, Ohio 43219

614-753-4690

[email protected]

1. Reading, Writing & Spelling Problems

Reading• Basic vs. Applied Skills• Perceptual Model of Reading• Decoding-Based Reading Problems (dyslexia)• The Six Syllable Patterns of English• Language-Based Reading Problems

Writing & Spelling• Perceptual Model of Writing & Spelling

2. Multi-Sensory, Structured Language

Big Ideas National Reading Panel Report

MSSL Approach

MSSL Programs - Wilson Reading System

– Scope & Sequence of Skills– Controlled Word Lists & Passages– Lesson Plan Format– Template for IEP Goals & Objectives– Sample Objectives (WRS)

3. Resources for MSSL Instruction

• Orton-Gillingham Derived MSSL Programs• Other MSSL Programs• Accommodations to Support Instruction

Interventions for Reading Comprehension

Interventions for Spelling

Interventions for Sentence Composition

Interventions for Paragraph Composition

Reading, Writing & Spelling Problems

Basic vs. Applied Skills

Basic Skills (K-3)

• Learning to Read

• Learning to Write• Learning to Spell

• Learning Math Concepts• Learning to Compute

Applied Skills (4-12)

• Reading to Learn

Get Information

• Writing & Spelling to

Demonstrate

Learning

• Applying Math Concepts

to Solve Problems


Basic vs. Applied Skills

Basic Skills (K-3)

Specially-Designed Instruction

• Reading• Writing-Spelling• Math

Applied Skills (4-12)

Accommodations

Changes made in the way materials are being presented or in the way the child demonstrates learning, as well as changes in setting, timing, and scheduling.


Perceptual Model of Reading

• Input Visual Pathway

• Processing Decoding Accuracy & Fluency

Comprehension

• Output Oral Reading Fluency


Input

Eye Fixations & Saccades• Rapid series of “stops” and “jumps”• .25 second average duration (fluent reader)• Fluent readers perceive each and every letter of print (ex. barn vs. bran)

Recognition Span• Number of letters/words seen during a fixation• 3-4 letters to the left of the focal point; 7-9 letters to the right

Return Sweep• Right-to-left eye movement required by the start of each new line of text

Eye Regression• Right-to-left eye movement (self-correction - homonyms, phrasing)


Input

The boys' arrows were nearly gone so they sat down on the grass and stopped hunting. Over at the edge of the woods they saw Henry making a bow to a little girl who was coming down the road. She had tears in her dress and also tears in her eyes. She gave Henry a note which he brought over to the group of young hunters. Read to the boys it caused great excitement. After a minute but rapid examination of their weapons they ran down the valley. Does were standing at the edge of the lake making an excellent target.


Input


Input

Halo Effect Washout Effect


Input

Rotational

ConfusionReversals(sequencing)


Input

ehT qaimtimg also qroved that, sa well sa beimg a great humter, Cro-Wagmom Nam saw a comsiberadle artist. He dah flourisheb ta a tine whem eno fo eht terridle Ice Ages saw dlotting out nuch fo Euroqe. He dah estadlisheb hinself, fought wilb aminals rof livimb sqace, surviveb eht ditter colb, amb tfel beeq bown umber groumb nenorials of his yaw fo life!


Input


Processing

DecodingDecoding is the ability to apply your knowledge of letter-sound relationships (phonics), including knowledge of letter patterns, to correctly pronounce written words.

Phonemic AwarenessPhonemic awareness is the ability to notice, think about, and work with the individual sounds in words. A student's skill in phonemic awareness is a good predictor of later reading success or difficulty.

Phonemic Awareness

• Speakers generate 10-15 phonemes per second

• Phonemes can be held in temporary memory for 1-2 seconds (max. 5-7 unrelated words)

• Co-articulation – the ability to “overlap” several phonemes, while maintaining integrity of each

• Specialized phonologic module in the brain recovers phonemes, translates into “particles of language”

Phonemic Awareness

However…

Phonemic segmentation (breaking words into individual sounds) is not part of our “automatic consciousness”

Example Say /slip/

Say the individual sounds in /slip/

/s – l – i – p/

Phonemic Awareness

Neurotypical “Milestones”

By 4-6 years of age

Awareness that words can “come apart” or “segment”

By 6 years of age

Ability to count phonemes in small words

Phonemic Awareness

Levels of Difficulty (Adams, 1990)

• Sensitivity to Rhyme (/sip/ - /lip/)

• Matching Words by Rhyme or Alliteration (/sip/ - /sat/ - /lip/)

• Segmenting Onsets from Rhyme (/tr/ - /ip/; /sl/ - /ip/)

• Full Segmentation (/t/ - /r/ - /i/ - /p/)

• Manipulation of Phonemes

Deletion – say /lips/ without /s/

Addition – say /lip/; say it again with /s/

Substitution – say /lip/; change /i/ to /a/

Phonemic Awareness

“Tell-Tale” Phonemic Awareness Skill

Phoneme deletion (requires segmentation & blending)

Example Say /slip/

Say it again, without /l/

/sip/

• Difficulties with phonemic awareness impairs decoding

• Also - Difficulties with rapid letter discrimination impairs decoding

Almost Everyone Speaks, But Not Everyone Reads

• Unlike phonemes, letters have no “inherent” linguistic connotation

• Writing is not language (a mode, not the code)

• Writing is complex; more than “speech written down”

Learning to speak is “natural”

Learning to reading is not

Almost Everyone Speaks,

But Not Everyone Reads

• 70-80% of American children transform print into phonemes without much difficulty (decoding)

• Decoding & comprehension are the major components of reading

• Older dyslexics use their ability to think and reason within context to guess words they can’t decode

Phonemic Awareness is “at the core” of dyslexia.

Why Some People Can’t Read

• Dyslexia: An unexpected difficulty learning to read despite intelligence, motivation, and education (“traditional” definition)

• Dyslexia is a “language problem” (not a general weakness in intelligence or visual impairment)

Dyslexia & Phonemic Awareness

• The phoneme (individual sound unit) is the fundamental element of the language system

• Difficulty developing awareness “that spoken and written words are comprised of phonemes”

• Difficulty retrieving the correct phoneme(s) (confusing with similar sounds - lotion for ocean)

• Difficulty sequencing phonemes correctly (emeny for enemy)

• Localized weakness in phonologic module of brain

Historical Roots of Dyslexia

• Rudolf Berlin (1887) – to lose the ability to read due to specific brain lesion; used the term “dyslexia”

• James Hinshelwood (1895) – an acquired difficulty in reading, not due to ophthalmologic reasons

• W. Pringle Morgan (1896) – difficulty with reading despite good eyesight & strong intelligence; used the term “word-blindness” (from birth)

• W. E. Brunner (1905) – first American report on “developmental alexia”

Reading & the Brain

• Paul Broca - established the roots of reading originate in the cerebral cortex (nerve cells near the surface of the brain – gray matter); Loss of speech is not due to the loss of movement - paralysis of the tongue (expressive aphasia)

• Carl Wernicke – flawless articulation without understanding (receptive aphasia)

Reading & the Brain

Samuel Orton (1925)

• Reading problems stemmed from failure of the left hemisphere to become dominant over the right

• Worked with Anna Gillingham who introduced a systematic approach for teaching “phonograms” to represent the 44 phonemes of English

Reading & the Brain

Sally Shaywitz (2007)

• fMRI is able to peer inside the brain as a person reads

• Determine (yes-no) if a pair of single-syllable, “non-sense” words rhyme (ex. rete-veet; mobe-haib)

Neurology of Dyslexia

Neurology of Dyslexia

Beginning Readers

Words slowly “sounded out” (word analysis)

Wernicke’s Area & Broca’s Area

Skilled Readers

Words rapidly decoded (word “form” stored – “automatic”)

Angular Gyrus

Dyslexic Readers

A disruption in the left posterior systems prevents rapid, automatic word recognition

Dyslexia Simulation

Confusion Over the “Logic of Phonics”

Ways to spell the sound /a/. made maid

ma – ple may

they weight

steak vein

Spell steak – cedeightck (c-ed-eigh-ck)

Dyslexia Simulation

Di Tri Berrese

Uans appona taim uas Tri berrese: mamma berre, pappa berre, a bebi berre. Live inne conti nire foresta. NAISE AUS. No mugheggia. Uanno dei, pappa, mamma, a bebi go tooda bice, onie, furghette locche di dorre.

Bai enne bai commonse Goldilocchese, sci garra nottinghe to du batto meiche troble. Sci puschie olle fudde daon di maute; not leave cromme. Dan sci gos appestrerres enne slipse in olle beddse.

LEISI SLOBBE!

Dyslexia Simulation

Bai anne bai commese omme di tri berrese, olle sonnebronde enne sand inne scius. Dei garra no fudde; dei garra no beddse. En wara die goine due to Goldilocchese? Tro erre inne strit? Colle pulissemenne?

FETTE CIENZE!

Dyslexia Simulation

Dei uas Intalina Berrese, enne die slippe onna florre.

Goldilocchese stei derre tree unidase; itte aute ausenomme, en guista becose die asche erro tu meiche di beddse, sci sei "Go to ell," enn runne omme criane to erre mamma.

Uatsiuse? Uara iu goine du - Go compliene sittolle?

Definition of DyslexiaInternational Dyslexia Association

• It is characterized by difficulties with accurate and-or fluent word recognition and by poor spelling and decoding abilities.

• These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction.

• Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth of vocabulary and background knowledge.

Definition of DyslexiaOhio HB 157

“Dyslexia” is defined as a specific learning disorder that is neurological in origin and that is characterized by difficulties with accurate or fluent word recognition and by poor spelling and decoding abilities, which difficulties typically result from a deficit in the phonological component of language.

Common Difficulties

Associated with Dyslexia

• Late-talking

• Difficulty pronouncing words (“bus-ghetti” for spaghetti; “mawn lower” for lawn mower; etc.)

• Slow to add new vocabulary words

• Difficulty with rhyming

Common Difficulties Associated with Dyslexia

• Difficulty learning the alphabet (letter-naming) and learning letter-sound correspondences

• Difficulty decoding words in isolation

• Confusion over small words (at – to; said – and; does – goes, etc.)

Common Difficulties


• Trouble remembering facts

• Difficulty spelling - may reverse letter sequences

(tap-pat; felt-left; causal-casual; etc.)

• Difficulty reading aloud and/or writing

• Difficulty with comprehension

• Difficulty with penmanship

• Often reads “below grade level”

Common Strengths


• Concept Formation

• Comprehension (listening)

• General Knowledge

• Problem Solving

• Vocabulary

• Critical Thinking

• Reasoning

Critical Skills to Test

Phonemic Awareness

• Sound Comparison

Which words begin with the same first sound

• Segmentation

Count or pronounce individual sounds of a syllable

• Blending

Combine sounds of a word that has already been

pulled apart


Phonologic Memory

• Holding phonemes in memory for blending into a word

• Holding words in memory for understanding a sentence

Rapid, Automatic Naming

• Similar to process performed when reading

• Ease and speed of retrieving stored phonemes

Knowledge of Letter Names & Sounds


Two most important skills to test:

• knowledge of letters & letter sounds• phonemic awareness

Familiarity with conventions of print (spacing of print, top-to-bottom, left-to-right) also helpful

IQ tests are not good predictors of later reading problems or, how well child will respond to intervention

Helping the Student with Dyslexia Learn to Read

• Learn to read by “sounding-out” and “taking bigger words apart”

• Learn to spell• Memorize sight words• Practice reading (oral & silent)• Practice fluency• Write letters and stories• Building words & worldly knowledge• Learn comprehension strategies

Helping the Student with Dyslexia

Learn to Read

The “Essentials” of Phonics

• Systematic & explicit phonics are the most effective

(National Reading Panel Report)

• Phonics allows the reader to decode words never seen before

• Critics of phonics never mention a lack of effectiveness in helping children learn to read by phonics instruction

(Shaywitz, 2003)

“De-Mystifying” the

“Logic of Phonics”

The Six Syllable Patterns of English

1. Closed

2. Vowel-Consonant-Silent E

3. Open

4. Consonant-LE

5. R-Control

6. Vowel Team

Closed Syllable

• Syllable ends in (or is “closed-off“ by) a consonant,

and has only one vowel

• The single vowel is usually short

(regular sound exceptions – ex. wild, colt)

Examples: at, keg, brim, cost, chunk

cat-nap, can-vas, dras-tic, sten-cil, con-sul,

rhom-bus, sus-pend

dis-con-tent, cos-met-ic, at-tend-ant

trans-at-lan-tic, in-hab-it-ant

ab, tel, phil, phon, ful

Vowel-Consonant-Silent e

• Syllable has a vowel,

followed by a consonant,

and the letter e (which is silent)

• The first vowel is usually long

(regular sound exceptions – ex. give)

Examples: ate, gene, bribe, chrome, flutes

name-sake, lime-stone, grape-vine

pack-age, Chi-nese, pro-vide, in-clude

mi-cro-scope

Open

• Syllable ends with a single vowel

(may be the only letter in the syllable)

• The single vowel is usually long

(however, “schwa happens” ex. A-lask-a)

Examples: a, me, hi, fro, flu, try

si-lo, ve-to, ha-lo, O-hi-o

a-gape, ta-ble, e-ject, tri-pod, ban-jo

man-ip-u-late

Consonant - le

• Syllable occurs at the end of a word and

contains a consonant

followed by the letters le

• The consonant and the l are sounded - the e is silent

(regular sound exception – castle, whistle)

Examples: crum-ble, un-cle, cra-dle, ri-fle, wig-gle,

an-kle, pim-ple, bat-tle

sol-u-ble, ve-hi-cle, be-fud-dle, rec-tan-gle

R - Controlled

• Syllable contains one vowel combined with the letter r

• The single vowel is neither long nor short

The vowel sound is “controlled” by the r

(regular sound exception – berry)

Examples: art, fern, chirp, cords, splurge

de-part-ment, or-der, gir-dle, ab-surd

Vowel Team

• Syllable contains two or more vowels together

(digraph or diphthong)

Examples: aid, load, fleet, beach

plaid, broad, bread, break, vein, eight, they

oil, soy, haul, crawl, loud, four, soup

blown, crown, book, boot

feud, blew, fruit, due

com-plain, re-proach, a-gree, rev-e-nue,

em-ploy-ment, eight-teen

Marking Syllable Patterns

dis rupt

em ploy

re cline

coun ty

Wis con sin

gir dle

deflate

charter

thyroid

cattle

tabloid

pensive

Marking Syllable Patterns

A little man lives in our garden.

• The sentence above contains all six syllable patterns (including a regular sound exception).

• Implications for Progress Monitoring – limit Oral Reading Fluency passages to syllable patterns introduced

Vocabulary-Based Reading Problems

Simulation

Last Serny, Fliggledobe and Pribin were in the nerd link. Suddenly, a ditty strezzle boofed into Fliggledobe’s tesk. Pribin glapped and glapped. “Oh Fliggledobe”, he chiffed, “that ditty strezzle is tunning in your grep!”

• When did this story take place?• Where were they?• What happened to Fliggledobe?

Perceptual Model of Writing

• Input Visual Pathway

• Processing Encoding Accurately & Fluently

Compose Sentences

Organize Paragraphs

• Output Writing with Pen-Pencil & Paper

Dysgraphia Simulation

• Penmanship & Spelling

Write while holding your pen or pencil in your opposite hand (with a palmer grip), complete a ten-item spelling test.

Spelling Test “Answers”

1. Acquiescence

2. Lieutenant

3. Beaux

4. Icicles

5. Teriyaki

6. Phenomena

7. Hemorrhage

8. Ostentatious

9. Sarsaparilla

10. Mayonnaise

National Reading Panel Report

The 5 “Big Ideas” of Literacy

1. Phonemic Awareness (sub-skill of phonological awareness)

2. Phonics

3. Fluency (accuracy, speed, phrasing, intonation, stress)

4. Vocabulary (oral, reading, subject-specific)

5. Comprehension (text explicit, text implicit & scriptal)

For Students with Dyslexia

More “Big Ideas”

1. Syllable Patterns – directly influence letter-sound relationships; provides structure for phonics

2. Morphology – how root, base and affixes can change the meaning or function of words (mid-upper level phonics)

3. Grammar – how words function as parts of speech

4. Syntax – word order as it affects meaning (sentence patterns & transformations)

5. Semantics – meaning at different levels (word, phrase, figures of speech, idioms, etc.)

Multisensory, Structured Language Approach

History of the English language

Sound-symbol relationships

Letter formation

Spelling generalizations

Dictionary use

Short and long vowel sounds

Digraphs

Diphthong

Affixes and roots

Word structure

Consonant sounds

Decoding and encoding words

Multi- Sensory, Structured Language Approaches (MSSL)

What is Taught?

• Phonology and Phonological Awareness: Phonology is the study of sounds and how they work within their environment, including the ability to segment words into their component sounds.

• Sound-Symbol Association: Sound-symbol association must be taught (and mastered) in two directions: visual to auditory and auditory to visual. Additionally, students must master the blending of sounds and letters into words as well as the segmenting of whole words into the individual sounds.

• Syllable Instruction: Instruction must include the teaching of the six basic types of syllables in the English Language. Syllable division rules must be directly taught in relation to the word structure.


What is Taught?

• Morphology: A morpheme is the smallest unit of meaning in the language. The curriculum must include the study of base words, roots, and affixes.

• Syntax: Syntax is the set of principles that dictate the sequence and function of words in a sentence in order to convey meaning, including grammar, sentence variation and the mechanics of language.

• Semantics: Semantics is that aspect of language concerned with meaning. The curriculum (from the beginning) must include instruction in the comprehension of written language.


How is It Taught?

• Simultaneous, Multisensory (VAKT): Teaching is done using all learning pathways in the brain (visual/auditory, kinesthetic-tactile) simultaneously in order to enhance memory and learning.

• Systematic and Cumulative: Multisensory language instruction requires that the organization of material follows the logical order of the language. The sequence must begin with the easiest and most basic elements and progress methodically to more difficult material. Each step must also be based on those already learned. Concepts taught must be systematically reviewed to strengthen memory.


How is It Taught?

• Direct Instruction: The inferential learning of any concept cannot be taken for granted. Multisensory language instruction requires the direct teaching of all concepts with continuous student-teacher interaction.

• Diagnostic Teaching: The teacher must be adept at prescriptive or individualized teaching. The teaching plan is based on careful and continuous assessment of the individual's needs. The content presented must be mastered to the degree of automaticity.


How is It Taught?

• Synthetic and Analytic Instruction: Multisensory, structured language programs include both synthetic and analytic instruction.

– Synthetic instruction presents the parts of the language and then teaches how the parts work together to form a whole.

– Analytic instruction presents the whole and teaches how this can be broken down into its component parts.

understanding dyslexia an introduction to effective intervention

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