Monday, November 7, 2016

Working Memory: The RAM of the Brain

Photo courtesy of http://examinedexistence.com
So what the heck is working memory?  I think of it as the RAM of our human computer, our brain. James has a relative weakness in his working memory. His score on the WISC -V was a standard score of 85; however, a score of just 79 is considered borderline. So this is quire a low score overall for James who is my highest cognitively-abled child. Margaret got a standard score of 62. This puts her in the severely impaired.  Joseph has a standard score of 79.  If you knew him you might find this surprising since he is SO slow due to his processing speed. Over time though, I have noticed that both Margaret and Joseph are both quite impaired.  I know now it is in different way.  Margaret has major working memory problems but is much faster at processing information.  Joseph on the other hand is SUPER slow in processing speed BUT he mas better working memory and long term memory.  Over time this will serve him better I think.

So what exactly is working memory? 

The computer, so useful a metaphor in cognitive psychology, offers an intuitively appealing model for thinking about the nature and structure of working memory.

Simplifying the workings of a computer, there are two means by which information is stored, the hard disk and random-access memory (RAM). The hard disk is the means by which information is stored permanently in a stable and reliable form; all software programs, data files, and the operating system of the computer are stored on the hard disk. To use this stored information you must retrieve it from the hard disk and load it into RAM. Now for the analogy: the information stored in the hard disk is like long-term memory, RAM corresponds to working memory.

The notion of working memory as a temporary workspace fits nicely: in a computer, RAM is cleared and reset when the task executed by the program is finished, or when the program is closed. The computer metaphor also suggests two further characteristics of working memory. First, RAM is completely flexible with regard to content. That is, there is no fixed mapping between the location of a part of RAM and the program that uses it; any program can access any part of RAM. Second, the more RAM a computer has, the more complex and sophisticated the programs that can be run on it, and the more programs that can be running simultaneously. Thus, if the computer-based metaphor of working memory holds, storage in working memory involves a content-free flexible buffer (the term in computer science for a limited-capacity memory store), and cognitive abilities are dependent on the size of the buffer. 

How well does this metaphor fit with actual human working memory structure and function? The evidence is not all in, but cognitive and neuroscience approaches to the study of working memory have in many ways revolutionized the types of questions that can be asked and provided new insights into how working memory works.

Working
memory is the mind’s ability to keep information for a short span of time, as you utilize such facts for the tasks and activities you need to do. It makes use of two lobes: the frontal lobe, which is responsible for planning, reasoning, emotions, problem-solving, movement and speech; and the parietal lobe, which governs the perception of stimuli such as pain, pressure, touch and temperature.

Since working memory is naturally brief, it makes use of attention and memory, but only for a short span of time. It is considered the foundation of the mind’s executive function, a group of mental processes that allows an individual to solve problems, plan ahead, pay attention and organize activities.

There are two types of working memory used by all individuals. They are:

1. Visual-Spatial Working Memory

Defined as the brain’s ability to use an ‘imaginary sketchpad,’ it enables a person to visualize something – and keep it in his mind’s eye. Individuals can use this type of working memory to remember images, sequences and patterns. It is also useful for computing mathematical equations in the mind.

The visuo-spatial sketch pad (inner eye) deals with visual and spatial information. Visual information refers to what things look like. It is likely that the visuo-spatial sketch pad plays an important role in helping us keep track of where we are in relation to other objects as we move through our environment (Baddeley, 1997).

As we move around, our position in relation to objects is constantly changing and it is important that we can update this information. For example, being aware of where we are in relation to desks, chairs and tables when we are walking around a classroom means that we don't bump into things too often!

The sketch pad also displays and manipulates visual and spatial information held in long-term memory. For example, the spatial layout of your house is held in Long Term Memory (LTM). Try answering this question: How many windows are there in the front of your house? You probably find yourself picturing the front of your house and counting the windows. An image has been retrieved from LTM and pictured on the sketch pad.

Evidence suggests that working memory uses two different systems for dealing with visual and verbal information. A visual processing task and a verbal processing task can be performed at the same time. It is more difficult to perform two visual tasks at the same time because they interfere with each other and performance is reduced. The same applies to performing two verbal tasks at the same time. This supports the view that the phonological (verbal) loop and the sketch pad (visual) are separate systems within working memory.

2. Auditory/Verbal Working Memory

Makes use of the mind’s phonological or sound system. A good example is repeatedly dictating a phone number while dialing it. While it cannot be retained while doing a certain a task, it is touted by many as a common learning disadvantage in most activities. Tasks that make use of verbal working memory include comprehension and language activities.



The phonological loop is the part of working memory that deals with spoken and written material. It consists of two parts. The phonological store (linked to speech perception) acts as an inner ear and holds information in speech-based form (i.e. spoken words) for 1-2 seconds. Spoken words enter the store directly. Written words must first be converted into an articulatory (spoken) code before they can enter the phonological store.

The articulatory control process(linked to speech production) acts like an inner voice rehearsing information from the phonological store. It circulates information round and round like a tape loop. This is how we remember a telephone number we have just heard. As long as we keep repeating it, we can retain the information in working memory.

The articulatory control process also converts written material into an articulatory code and transfers it to the phonological store.

How is your working memory?


IS (5 x 3) + 4 = 17? BOOK
IS (6 x 2) - 3  =  8?  HOUSE
IS (4 x 4) - 4  = 12? JACKET
IS (3 x 7) + 6 = 27? CAT
IS (4 x 8) - 2  = 31? PEN
IS (9 x 2) + 6 = 24? Water

To take this test yourself, cut out a window in a blank sheet of paper so that it exposes only one line at a time. For each line, determine whether the arithmetic is correct or not: say, out loud, “yes” or “no.” Then look at the word that follows the problem and memorize it. Move through each line quickly. After you have finished all the lines, try to recall the words in order. The number you get correct is an estimate of your working memory capacity. Very few people have a working memory as high as 6; the average is around 2 or 3.


Working Memory and the Brain

A good example of an everyday activity that uses working memory is mental arithmetic. Imagine, for example, attempting to multiply two numbers (e.g., 43, 27) spoken to you by another person, without being able to use a pen and paper or a calculator. First of all, you would need to hold the two numbers in working memory. The next step would be to use learned multiplication rules to calculate the products of successive pairs of numbers, adding to working memory the new products as you proceed. Finally, you would need to add the products held in working memory, resulting in the correct solution. To do this successfully, it is necessary to store the two numbers, and then systematically apply multiplication rules, storing the intermediate products that are generated as we proceed through the stages of the calculation. Without working memory, we would not be able to carry out this kind of complex mental activity in which we have to both keep in mind some information while processing other materials. Carrying out such mental activities is a process that is effortful and errorprone. A minor distraction such as an unrelated thought springing to mind or an interruption by someone else is likely to result in complete loss of the stored information, and so in a failed calculation attempt. As no amount of effort will allow us to remember again the lost information, the only course of action is to start the calculation afresh. Our abilities to carry out such calculations are limited by the amount of information we have to store and process. Multiplying larger numbers (e.g., 142 and 891) “in our heads” is for most of us out of the question, even though it does not require greater mathematical knowledge than the earlier example. The reason we cannot do this is that the storage demands of the activity exceed the capacity of working memory.

In an experimental setting, an individual’s working memory capacity is reliably assessed by tasks in which the individual is required to process and store increasing amounts of information until the point at which recall errors are made. An example of such a task is reading span, in which the participant makes judgments about the semantic properties of sentences while remembering the last word of each sentence in sequence. Tasks of short-term memory, in contrast, place menial demands on processing and are often described as storage-only tasks. Verbal short-term memory is traditionally assessed using tasks that require the participant to recall a sequence of verbal information, such as digit span and word span. Visuo-spatial short-term memory tasks usually involved the retention of either spatial or visual information. For example, in the Visual Patterns Test, the participant is presented with a matrix of black and white squares and has to recall which squares were filled in. The Corsi blocks task is an example of a spatial memory task, and participants have to recall the sequence of blocks that are tapped. Individual differences in the capacity of working memory appear to have important consequences for children’s ability to acquire knowledge and new skills.

Working Memory, Reading, and the Dyslexia Connection

Children may be described as dyslexic if their reading, writing and spelling skills are significantly worse than those of their typically developing peers. Dyslexia is now understood as a problem with Verbal Working Memory, where the Phonological Loop (verbal short term memory) does not function as it should, and the verbal portion of the Central Executive, responsible for concentration, attention, planning and other executive functions, is also affected.

Some symptoms of dyslexia arise as a direct result of poor Verbal Working Memory, such as poor reading, spelling, verbal comprehension, difficulty learning sequences and problems with organisation. Children with learning difficulties may also suffer from a lack of confidence and poor self-esteem.

A full diagnostic assessment is required to discover your child's pattern of strengths and weaknesses.  This can be done by request a full psycho-educational testing from the school.  If you homeschool you can request testing from your local school district under the Child Find guidelines, you can request a referral from your child's pediatrician to a pediatric psychologist, or you can request a referral and evaluation from a neuropsychologist.

What is Reading Comprehension?
Comprehension describes the interactive process between the reader and the text. Children with similar decoding and word recognition skills may vary in their understanding of material because their comprehension skills are at different levels. Listening and reading comprehension depend on language and cognition. Listening comprehension also depends on well-developed auditory skills. Prerequisite skills are:
  • vocabulary
  • grammatical skills
  • pragmatic skills
  • meta-linguistic awareness
  • shared understanding (social; cultural)
  • attention; sequencing
  • monitoring
  • working memory
When Working Memory skills are poor, children will struggle to retain information they read or hear for long enough to integrate it with existing understanding. This is particularly important when listening to, or reading, sentences with embedded clauses. Center-embedded clauses can be really difficult because this structure creates three sections to be analysed, overloading children with poor Working Memory. As we hear or read new information, we continually recode the material into chunks, discarding irrelevant detail and retaining the gist. Working Memory is crucial for this level of processing and enables us to manage longer texts. Working Memory is crucial for generating inferences because the reader needs to keep in mind a representation of the relevant section of text, while conducting searches for information, either in long term memory or other places in the text, before checking that the inference makes sense. Working Memory is also crucial for monitoring that incoming information makes sense. Children need to notice words they don't understand as well as contradictions and anomalies. Strategies to clarify information they don't fully understand may involve looking back to check that a word has been read correctly, or formulating and asking clarifying questions, all of which place demands on Working Memory.

Working Memory and Math (Dyscalculia)

It was found that the children in the dyscalculia and maths anxiety groups showed different types of working memory impairment. The dyscalculia group, when compared to the typically developing group, performed worse on the visual-spatial working memory task. This agreed with previous research which showed a link between DD and poor visual-spatial working memory ability3. The maths anxiety group, on the other hand, were more impaired in verbal working memory than the dyscalculia group. The maths anxiety group was also impaired in visual-spatial tasks but only when a higher working memory load was used (i.e. there were a large number of objects to be memorized). This finding supports the idea that anxiety may use up working memory resources which leads to poor maths performance4.

Working Memory and General Academic Performance 

Let’s say a child, Margaret, is presented with a mental math calculation such as, “find the sum of 2, 5, and 10”. She must remember all of numbers that need to be added, hold that information in mind while adding the numbers and ignoring distractions in her environment, and then produce the sum of 17. Children with poor working memory like Margaret might miss the middle number and produce a sum of 12. For reading comprehension of a passage, Margaret would need to read each sentence and hold them in mind while also making sense of their meaning. She would need to simultaneously process and store the information in the passage over a short time period. Common failures of working memory during academic tasks are reflected in skipping letters or words, blending together different words or sentences, and losing track of sentences or numbers (Holmes et al., 2010). All these working memory related failures result in Margaret being unable to correctly calculate a math problem or make sense of a reading passage.

It is estimated that 80% of children with poor working memory struggle with math, reading, or both (Gathercole & Alloway, 2008). Further, low achievers are three times more likely and students with special educational needs are six times more likely to have low working memory compared to typical learners (Holmes et al., 2010). What this tells us is that the majority of students that perform poorly in school or that require additional support have working memory deficits. It is these kids who become overloaded during regular classroom activities, such as those involving multi-step instructions, and miss important learning opportunities (Gathercole & Alloway, 2008). It is these children with low working memory that we find staring out the window with their minds wandering (Kane et al., 2007) when tasks get too tough and working memory gets overloaded.

Working Memory Training...Real or Hype?
Working memory training information is ALL over the place on the internet.  There are a TON of programs on how to increase working memory.  Sadly, there is nothing that can really help with poor working memory. There has been more research showing memory training is more helpful in reading versus math.  There has been no research showing memory training helps overall cognitive ability.  You can do programs training working memory but the effects have been shown to be short term and with the high cost of the programs it just is not worth pursuing.
www.hydrocephalusscotland.org.uk

Sign of Working Memory Deficits

If your child exhibits 2-3 of these behaviors in this checklist there may be some cause for concern:
  • A need to re-read text
  • Test anxiety, especially on multiple choice tests
  • A need for more time and repetition
  • Inconsistent performance
  • Lack of focus and attention deficit disorders
  • Is easily distracted when working on or doing something that is not highly interesting.
  • Has trouble waiting his/her turn, for example in a conversation or when waiting in line to get help.
  • Struggles with reading comprehension and has to read through texts repeatedly to understand.
  • Struggles with problem solving that require holding information in mind, for example mental math calculations.
  • Is inconsistent in remembering math facts.
  • Struggles with completing tasks, especially multiple step tasks.
  • Has difficulty remembering long instruction given in several steps, for example following recipes, directions or school/work assignments.
  • Struggles to understand the context in a story or a conversation.
  • Has difficulties when planning and organizing something that needs to be done in separate steps.
  • Has difficulty staying focused during cognitive demanding tasks but attends well when cognitively demands are minimal.
  • Has difficulty integrating new information with prior knowledge.
  • When called on, forgets what he/she was planning to say.
  • Has difficulty taking notes and listening at the same time.

Several of these working memory-specific symptoms are associated with multiple learning diagnoses, and indication of how critical working memory is to many learning abilities.

Learning Efficiency
Academic success is dependent on a number of skills working at a high level, many of which involve working memory: for instance, being able to retain information in class, reading with comprehension, and attention stamina.

Attention Deficits
Poor working memory skills impacts attention because if students cannot hold information as it is coming at them, it is harder to engage. These children tend to be more easily distracted and are often diagnosed as having inattentive ADD.

Reading & Dyslexia
Several of the symptoms above impact reading — both in learning to decode, and in reading efficiency for comprehension. Most of the time in reading though, the true difficulty is phonological awareness. An inability to retain text while reading more often not due to inefficient and exhausting decoding, not working memory problems.

Testing for Working Memory

One of the most common tests used to determine working memory capacity is the WISC V (Wechsler Intelligence Scale for Children®-Fifth Edition).  This test has a whole subsection for Working Memory. 

Another test that may be used is the WAIS IV (Wechsler Adult Intelligence Scale®- Fourth Edition).  This test also has a subsection for Working Memory testing.

Both tests are highly recognized and work well in measuring Working Memory. 

Working Memory Accommodations and Modifications

MONITOR THE STUDENT 
Ask the student to verbalize their steps in completing tasks they often struggle to complete. This can provide important information about where the breakdown is occurring and what supports are likely to work best. 
• Evaluate the working memory demands of learning activities. A student with working memory difficulties will need more support as tasks get longer, become more complex, have unfamiliar content or demand more mental processing. 
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REDUCE THE MEMORY LOAD 
• Break tasks into smaller chunks. One task at a time is best, if possible. 
• Reduce the amount of material the student is expected to complete. 
• Keep new information or instructions brief and to the point, and repeat in concise fashion for the student, as needed. 
• Provide written directions for reference. 
• Simplify the amount of mental processing required by providing several oral “clues” for a problem and writing key words for each clue on the board or interactive whiteboard. This way the student does not have to hold all of the information in mind at once. 
• Increase the meaningfulness of the material by providing examples students can relate to. 
• Provide information in multiple ways: speak it, show it, and create opportunities to physically work with it or model it. 
• Develop routines, such as specific procedures for turning in completed assignments. Once a routine is practiced repeatedly, it becomes automatic and reduces the working memory demand.

REPEAT AND REVIEW 
• Be prepared to repeat information. 
• Use visual reminders of the steps needed to complete a task. 
• Provide opportunities to repeat the task. 
• Encourage practice to increase the amount of information encoded into memory. 
• Teach students to practice in short sessions, repeatedly throughout the day. Spaced practice is more effective than massed practice. Have students practice new skills or information in short sessions over the course of the day rather than in one long session. For example, give the student a set of key facts to review for a few minutes two or three times during the school day, and encourage them to review again at home both at night and in the morning. 

USE ADVANCE ORGANIZERS 
• Use advance organizers and teach students how to use them. For example, KWL (What I Know, What I Want to Know, What I Learned) is a graphic organizer that helps students focus on what is to be learned. This tool activates prior knowledge, helps generate questions to explore and then assists students to connect what they learn to what they already know. 

TEACH STEP-BY-STEP STRATEGIES 
• Teach one strategy at a time in brief, focused sessions. 
• Teach students when, where, why and how to use the strategy
• Review and activate prior knowledge. 
• Be overt and explicit. 
• Model and think aloud. 
• Have skilled students model steps.
• Encourage use and practice. 
• Evaluate and recognize effort and success. 
• Encourage self-monitoring. 
• Promote transfer to other situations, times, activities and groups.

ENCOURAGE THE USE OF MEMORY AIDS 
• Use visual posters, e.g. of multiplication tables. 
• Create posters of commonly used words. 
• Provide instructions in written form – could be a handout, whiteboard, or simply a sticky note. 
• Provide a key word outline to refer to while you are teaching. 
• Encourage the use of checklists for multi-step tasks (e.g., steps for editing written work, timelines for assignments). 
• Encourage students to make lists of reminders regularly. 
• Use graphic organizers to teach new concepts and information. When the student can picture how the ideas are interrelated, they can be stored and retrieved more easily. 
• Consider educational technology that reduces the demand on working memory, such as calculators, word processors, spell-check devices, grammar-check devices, and voice dictation and text readers. 
• Use rhymes, songs, movements and patterns, such as ’30 days hath September’ rhyme for remembering the number of days in each calendar month. Music and physical routines linked to fact learning can help students memorize faster and act as a cue for retrieving specific information. 

PAUSE, PARAPHRASE, SUMMARIZE AND ALLOW TIME 
• Stop at least two times per lesson and request a quick summary from students – “what have we learned so far?” – followed by quick notes on the board. Research overwhelmingly indicates that at least 40% of total learning time needs to be spent reviewing new material. 
• Request students to paraphrase, or have another student paraphrase verbally delivered directions. Research has repeatedly shown that youth are more likely to “hear” and “remember” if they hear their own voice or a peer’s voice. 
• Allow time for rehearsal and processing. 
• Allow extra time for the student to retrieve information. These students benefit from advance warning that they will be asked a question. 
• Avoid open-ended questions. 

GET PHYSICAL 
• Active participation with the material such as repeatedly hearing it, seeing it and moving it, holds the information in working memory so it can move to long-term memory. Let the students move around, use hands-on material and put information on file cards so they can be manipulated. 
• Wherever possible, use games such as Jeopardy® and Scrabble®, drama and art to reinforce concepts. 

COLOR CODE 
• Physical coding, such as consistent colors for different subject areas, can act as triggers to help students remember information. o Try coding when teaching new concepts: when teaching sentence structure nouns are always red, verbs are always green etc. o Spelling – highlight difficult parts of new words. 
• Vocabulary – teach new words in categories or families and color code the categories. o Encourage the use of colored pens or highlighters (remember, yellow is the LEAST effective). 

MAKE OVERT LINKS 
• Try to get the students to link new information to prior knowledge – encourage drawing, writing and verbal reflection. The use metaphors, analogies, imagery or induced imagery (where the image is generated by the individual, rather than given to them) can help. 
• Start each lesson with a quick review of the previous lesson – always write down key words as the students recall information to model “trigger words”. 
• End each lesson with a summary of what was learned. 

KEY WORDS 
• Teach students to listen for key words. Post the words in the classroom and frequently use them as cues while you teach. 
• Often students with working memory difficulties also exhibit word and information retrieval difficulties. They frequently experience the “tip of the tongue” phenomenon, or may produce the wrong details within the correct concept. The student may need additional time to retrieve details when answering a question. Cues may be necessary to help them focus on the correct bit of information or word. 

TEST TAKING 
• Allow extra time, or reduce the number of questions. 
• Consider requiring recognition vs. recall. 
• Teach students to scan the test and plan their time allocation. 
• For essay tests, teach students to create an outline, write key words in point form and then expand on the key words and ideas. 
• Where possible, allow students to use reference sheets during tests (e.g., math formula, chronologies of events), or encourage students to create reference sheets at home, to rehearse the information frequently and then to rewrite the information at the beginning of the exam before attempting to answer the questions. 
• A student with difficulties sustaining working memory often needs frequent short breaks. Breaks typically only need to be one or two minutes in duration. Observing when the student’s ability to focus begins to wane will help determine the optimal time for a break. 
• Use technology such as word processors, speech-to-text, and text-to-speech programs to reduce working memory demand, and allow for additional time to complete tasks. 

REINFORCE LEARNING PREFERENCES 
• Encourage self-reflection for yourself and the student. What worked for me? What could I do next time? If this strategy worked for this task, could I use it anywhere else? 
• Many software programs and applications can provide rehearsal in an entertaining fashion and are often less demanding of working memory.

Wrap Up

I hope this article has been helpful.  Please click on the embedded links for source material.  I know this has helped me understand the importance of Working Memory and I hoped it helped you do the same.  Please leave any questions or comments below.

Saturday, October 15, 2016

October Pregnancy and Infant Loss Awareness 2016

Time to come of the shadows and stigma of pregnancy and infant loss.  Though it hurts me to talk about my daughter I would not have it any other way.  She was here, she was alive, and she deserves to be remembered. I love you my sweet baby Martha.  




Friday, October 7, 2016

Why Does It Take So Long For Special Education Services?

I had to enroll the children into an online public school.  I needed to do this to take advantage of my of state's program called the Empowerment Scholarship.  It is a program where parents basically waive their rights to FAPE so parents can get a pot of money to send their child to private school or homeschool. We will be going back to homeschooling after our short visit to public school.


Being in the public school has definitely showed me areas where my children are weak academically!  I submitted the request for special education testing within the first week of school (first week of August). The way my state works is that you have a MET (Multidisciplinary Evaluation Team) I meeting to discuss educational concerns and for the parent to turn over any information on your child to show a disability.  I had been writing the blog posts on neurocognitive domains just so I could better explain my children to the team.  First round went to me since the MET group said my kids were suspected of having a learning disability. They decided that there was more testing they needed/wanted to do so the team could appropriately classify them for special education.  That meeting happened on August 17th.

So the days passed and I waited to hear from the school specialists. I heard from the one by one.  I set appointments with them and took the kids to be tested or specialists come here.  Two weeks the kids went though various tests. The MET II meets were set for October 4th and 5th.  I took Joseph and James's together and the next day was Margaret's meeting.  I asked for a copy of the meeting materials that any of the other team members would have access to before the meeting.  This allowed me to be on even ground.  I was able to read the reports the say before.  Is it bad to say I laughed?

Why did I laugh?  Because the reports pointed out SO starkly many of the things I knew to be "wrong" with my children.  Here are some comments from James's report... From the psychologist, "Mom managed the full schedule of the home very well."  Why thank you!  I try though I often wonder how I really do. "He (James) presented as friendly, helpful, talkative, and was a bit of a squirrel/tease at time, which is reportedly not unusual for him."  I have to admit I found this funny.  Yes, James is talkative and he often plays around which makes it hard to tell sometimes when he is being serious. "He was fidgety throughout both sessions, moving about his chair, twisting his shirt into a variety of positions, even lifting it over his head a few times and once taking it off."  ROFL  This really got me! I see James pull his shirt over his head quite often lately.  He reminds me of the character on Bevis and Butthead.  LOL  His shirt was bothering him so much he pulled his shirt all the way off!  Yes, my baby still has sensory issues and has a problem being still due to sensory and ADHD issues.

During his testing for speech she talks about how he turned backwards in his chair several times and only turned around to look at pictures as needed.  "Depite the busy-ness of his body, he still presented as having a calm demeanor. Ja attempted to peek between the barriers this SLP had set up to block his view of the test booklets, when the SLP adjusted them to close the small crack, Ja responded by smiling, chuckling, and saying "Darn it!""  This is James and his perfectionist attitude.  He has anxiety if he thinks he is doing something wrong. "Ja does become "stuck"  on topics of high interest..."  Yes, yes he does!  This is part of his autism and lack of cognitive flexibility.  "Eye contact was appropriate at time, but fleeting to non-existent at other times."  Very much a typical autism trait.  "He was quite verbose and frequently used tangential speech; he required ongoing verbal cues to limit the number of his extraneous comments and keep on-topic."  LOL   Yes, James has a LOT to say but only 50% of the time would I say he is on topic.

You can see how these things are both hard to hear yet funny because you know these professionals are seeing your child for the first time.  I know all these things about James and in the homeschool environment I can build the environment to suit his needs.  I can do some of that in the online public school but his inattention, internal dialog, his dysgraphia, his sensory issues, and his math calculation problems, and I am sure I missing other things, are ALL issues that impede his learning, even online.   I could only imagine if I sent him to a regular brick-and-mortar school what would happen to him with his inability to sit and pay attention along with his general disruptive behavior.

Margaret and Joseph had worse results in their reports.  After about four hours discussion there are a couple of things I forgot for James.  I think James may have a specific learning disability in math calculation (dyscalculia) and I know he has a specific learning disability in written expression (dysgraphia).  We will need to cover this on or before his IEP is formulated.


In the end the MET II team has decided these special education eligibility categories belong to the children so far...

James: Primary: Autism; Secondary: OHI - ADHD (I need to see about adding the SLD: math calculation and SLD: written expression)

Margaret: Primary: Autism; Secondary: SLD: math calculation, SLD: math problem solving, SLD: written expression, OHI - ADHD

Joseph: Primary: Multiple Disability with Severe Sensory Impairment (Autism and Visual Impairment fall under here along with Joseph's problems with math and writing); Secondary: OHI - Ataxic Cerebral Palsy


Do these things shock me in any way?  No.  It is a bit hard to read in a report where everything is written so starkly in black and white. I am thankful the school has identified most, if not all, the children's needs.  Now we are waiting (and it can be up to 30 more days) to work on developing the IEP for the children.  Then the fighting will really begin.  LOL  Once our 100 days are up in public school, near the end of January, I will look at how the kids are doing in school.  I highly suspect that I will be pulling Margaret and Joseph back out of public school for homeschooling once again.  I cannot wait!  The pace of public school is just too fast for them.

Thursday, October 6, 2016

Why Good Visual Processing (all 8 kinds) Is Important!

Did you know 65% of the population are visual learners? Now, what do you do when you have a child that has vision loss in one eye, reduced peripheral vision in the other eye, BUT is STILL a visual learner?  Think about that for a minute.  Yes, Joseph, my son with only one "good" eye, is a visual learner. Joseph has problems with visual-spatial reasoning among other visual processing issues.  As it turns out, all my children have visual-spatial problems. They all score in the 5 to 18 percentile in visual-spatial reasoning.  So how does an issue with visual-spatial reasoning impact learning?  I hadn't a clue so I wrote this post to understand!  Hopefully you, dear reader, will find it helpful too!

In a paper by Franceschini et al., there is a strong correlation to visual-spatial attention and learning to read. The children who had the most difficulty with visual-spatial discrimination had most difficulty in learning to read and often went on to be diagnosed with dyslexia.  Mayer et al., found a correlation in visual-spatial reasoning, along with cognitive ability and problem-solving skills, were the deciding factors in determining the scientific reasoning skills of elementary school students. What I really found interesting was the paper by Tosto et al., which studied the visual-spatial abilities of several sets of 12 year old twins. By 12, a bit over half of your visual spatial skills you got from your parents (genetics) but the rest is learned (this was true for both boys and girls).  The part of the paper I found interesting is that the same pathways in the brain for visual-spatial reasoning is used for math and science. Who knew?  This explains a lot as to why children with developmental dyscalculia have issues with processing visual-spatial information.





What are the signs of Visual Processing Disorder?

There are EIGHT types of visual processing disorders. These are:
Visual Discrimination
  • Can't match clothing, socks, or cutlery, especially when the differences are subtle
  • Doesn't noticing the similarities and differences between certain colors, shapes and patterns
  • Will not see differences between similar looking letters and words (eg b / d, b / p, 5 / S, won’t / want, car / cat)
  • Will have a hard time reading maps
Visual Figure-Ground Discrimination
  • Struggles to find information on a busy blackboard
  • Finds it hard to copy work from the board as the child keeps losing his place when copying
  • Loses his/her place on the page while reading
  • Has poor dictionary skills
  • Struggles with map work
  • Struggles to find personal items in a cluttered place
Visual Sequencing
  • Has difficulty using a separate answer sheet
  • Cannot stay in the right place while reading a paragraph. Example: skipping lines, reading the same line over and over
  • Problems reversing or misreading letters, numbers and words
  • Has difficulty understanding math equations
Visual Motor Processing
  • Has difficulty writing within lines or margins of a piece of paper
  • Struggles to copy from a board or book
  • When moving around often bumps into things
  • Has problems participating in sports that require well-timed and precise movements in space
Visual Closure
  • The inability to know what an object is when only parts of it are visible
  • Not recognizing a picture of a familiar object from a partial image. Example: A truck without its wheels
  • Misidentifying a word with a letter missing
  • Not recognizing a face when one feature (such as the nose) is missing
Spatial Relationships
  • Difficulty getting from one place to another
  • Has a problem spacing letters and words on paper
  • Cannot judge time
  • Reading maps and giving directions are difficult
Plus there are other vision processing disorders like Irlen Syndrome, visual dyslexia, and visual dyspraxia.



Who Diagnoses Visual Processing Disorders and How to Treat It?

This is hard to determine.  Visual Processing Disorder is NOT a learning disability be itself.  It is only a learning disability IF it interferes with the learning process.  Ah, the fun of public education! If you homeschool it is easier because you can implement the accommodations and modifications at home to see if academic function improves.

If you are looking to pursue a diagnosis look for an opthamologist, vision specialist, vision therapist, or a neuropsychologist. One of these professionals should be able to run the psychometric tests needed to make a diagnosis.

There are three kinds of therapies that are important to be aware of as you’re considering ways to help your child with visual processing issues.

Optometric vision therapy: It’s important to note that there is more than one kind of vision therapy. Optometric vision therapy has been proven to help with vision problems that involve eye movements or eye alignment. These eye coordination issues are different from visual processing issues. Visual processing issues involve the way the brain processes the information the eyes take in.

You may hear some kinds of optometric vision therapy referred to as “orthoptic vision therapy.” Both can help with eye muscle and eye alignment. These kinds of therapy can help with vision problems such as convergence insufficiency (when the eyes don’t work together properly when trying to focus on a nearby object).

Optometric vision therapy doesn’t “cure” learning and attention issues. But if your child has vision problems in addition to dyslexia and other issues, resolving vision problems can help him devote more energy to finding strategies that can help with the way his brain processes information.

Behavioral vision therapy: This is different from optometric vision therapy. Behavioral vision therapy involves eye exercises that are designed to improve visual perception. These eye exercises are also designed to improve visual processing skills. But there is no scientific research that shows this kind of therapy helps the brain process visual information. For that reason, behavioral vision therapy is considered a controversial treatment for learning and attention issues.

Anecdotal evidence suggests that it may help some children. But be wary of any treatment that claims to “cure” learning and attention issues. Learn more about how to know when a treatment is reputable.

Educational therapy: Children with visual processing issues may benefit from educational therapy. This type of therapy teaches kids strategies for working around their weaknesses. Learning how to approach problems can reduce frustration, increase self-confidence and lead to greater success in school.

What are appropriate accommodations or modifications? 

  • Use books, worksheets and other materials with enlarged print
  • Read written directions aloud. Varying teaching methods (written and spoken words; images and sounds) can help promote understanding
  • Be aware of the weakness but don't overemphasize it. While helping a child work on the weakness is important; it is just as important to build other skills and function in any setting
  • Break assignments and chores into clear, concise steps. Often multiple steps can be difficult to visualize and complete
  • Give examples and point out the important details of visual information (the part of a picture that contains information for a particular question)
  • Provide information about a task before starting to focus attention on the activity
  • Allow student to write answers on the same sheet of paper as the questions or offer opportunities for student to explain answers orally
  • Provide paper for writing and math work that has darker or raised lines to make the boundaries more distinct
  • Organize assignments to be completed in smaller steps instead of one large finished product
  • Use a ruler as a reading guide (to keep focus on one line at a time) and a highlighter (to immediately emphasize important information)
  • Provide a tape recorder to supplement note-taking
  • Color code important information
  • Have a proof-reading buddy for all written materials
  • Use a tape recorder when getting important information
  • Before writing letters or essays, create an outline to simplify and organize ideas
  • Have a proofreading buddy for notes and essays

I hope you found this post helpful.  I had initially started this post just to discuss visual-spatial processing but as I started to research the subject I found there was so much more to cover!  I think I did a decent job overall to cover everything in a broad way. If I missed anything please let me know!  I you have any questions you can contact me on the blog or though Facebook.


Wednesday, September 14, 2016

What is Dyscalculia and Dysgraphia?



So what exactly is a Specific Learning Disability (SLD) in Math or Writing? The Office of Special Education for the U.S. Department of Education is encouraging schools to use the words Dyscalculia and Dysgraphia in Individual Education Plans (IEPs) and 504s. The except from the letter below contains the link to the whole document.

The Office of Special Education and Rehabilitation Services (OSERS) has received communications from stakeholders, including parents, advocacy groups, and national disability organizations, who believe that State and local educational agencies (SEAs and LEAs) are reluctant to reference or use dyslexia, dyscalculia, and dysgraphia in evaluations, eligibility determinations, or in developing the individualized education program (IEP) under the IDEA. The purpose of this letter is to clarify that there is nothing in the IDEA that would prohibit the use of the terms dyslexia, dyscalculia, and dysgraphia in IDEA evaluation, eligibility determinations, or IEP documents.

So now that the terms Dyscalculia and Dysgraphia have been sancuned for use lets looks at what exactly are these little known disabilities.

Dyscalculia  

http://www.k12academics.com


Dyscalculia is defined as difficulty acquiring basic arithmetic skills that is not explained by low intelligence or inadequate schooling. About 5% of children in primary schools are affected. Dyscalculia does not improve without treatment. Many people with dyscalculia have associated cognitive impairment (e.g., impairment of working memory and visuospatial skills), and 20% to 60% of those affected have other diagnosed conditions such as dyslexia or attention deficit disorder.




Currently (January 2015) a search for ‘dyscalculia’ on the Department for Education’s website gives 0 results as compared to 44 for dyslexia, so the definition below comes from the American Psychiatric Association (2013):

Developmental Dyscalculia (DD) is a specific learning disorder that is characterised by impairments in learning basic arithmetic facts, processing numerical magnitude and performing accurate and fluent calculations. These difficulties must be quantifiably below what is expected for an individual’s chronological age, and must not be caused by poor educational or daily activities or by intellectual impairments.

Because definitions and diagnoses of dyscalculia are in their infancy and sometimes contradictory, it is difficult to suggest a prevalence, but research suggests it is around 5%. However, ‘mathematical learning difficulties’ are certainly not in their infancy and are very prevalent and often devastating in their impact on schooling, further and higher education and jobs. Prevalence in the UK is at least 25%.

Developmental Dyscalculia often occurs in association with other developmental disorders such as dyslexia or ADHD/ADD. Co-occurrence of learning disorders appears to be the rule rather than the exception. Co-occurrence is generally assumed to be a consequence of risk factors that are shared between disorders, for example, working memory. However, it should not be assumed that all dyslexics have problems with mathematics, although the percentage may be very high, or that all dyscalculics have problems with reading and writing. This latter rate of co-occurrence may well be a much lower percentage.

Typical symptoms of dyscalculia/mathematical learning difficulties:
  • Has difficulty when counting backwards.
  • Has a poor sense of number and estimation.
  • Has difficulty in remembering ‘basic’ facts, despite many hours of practice/rote learning.
  • Has no strategies to compensate for lack of recall, other than to use counting.
  • Has difficulty in understanding place value and the role of zero in the Arabic/Hindu number system.
  • Has no sense of whether any answers that are obtained are right or nearly right.
  • Tends to be slower to perform calculations. (Therefore give less examples, rather than more time).
  • Forgets mathematical procedures, especially as they become more complex, for example ‘long’ division.
  • Addition is often the default operation. The other operations are usually very poorly executed (or avoided altogether).
  • Avoids tasks that are perceived as difficult and likely to result in a wrong answer.
  • Weak mental arithmetic skills.
  • High levels of mathematics anxiety.
  • When writing, reading, and recalling numbers, may make mistakes: number additions, substitutions, transpositions, omissions, and reversals
  • Difficulty with abstract concepts of time and direction
  • Inability to recall schedules and sequences of past or future events
  • May be chronically early or late
  • Inconsistent results in addition, subtraction, multiplication, and division
  • Inability to visualize, appear absent-minded, or lost in thought
  • Inconsistent mastery of math facts
  • Difficulty with left and right orientation
  • Difficulty following sequential procedures and directions in math steps
  • Slow in understanding math concepts in word problems
  • Confuse operations signs or perform them in the wrong order
  • Confuse part to whole relationships
  • Difficulty keeping score during games 
  • Limited strategic planning ability
Since mathematics is very developmental, any insecurity or uncertainty in early topics will impact on later topics, hence to need to take intervention back to basics.


So what can be done to help a child with Dyscalculia?


There aren’t specific therapies for kids with dyscalculia. But you may want to explore educational therapy. This type of therapy helps kids with different kinds of learning and attention issues develop strategies for working around their issues and dealing with frustration. An educational therapist may be able to help your child get better at working with numbers.

Kids with dyscalculia may have trouble reading and articulating the language of math. In these cases, speech therapy could be helpful.

Kids with dyscalculia may also have trouble with visual-spatial skills. For example, they may struggle to judge distances between objects. If this is the case for your child, you might want to explore occupational therapy and/or vision therapy.

Children with dyscalculia may be dealing with other issues that emotional therapy can help with. For example, ADHD and dyscalculia often co-occur. So it may be recommended that your child try therapies to address aspects of his ADHD.

These kinds of therapies may lessen some of your child’s anxiety about school and make it easier for him to perform in class. The same may be said for psychological counseling if dyscalculia takes a toll on your child’s self-esteem or causes anxiety or stress.


Classroom Accommodations and Modifications

  • Allow extra time on tests. Children with dyscalculia will often feel rushed during standard-length math tests. If possible, avoid timed tests of basic facts like multiplication tables, which can be a roadblock for LD kids.
  • Provide frequent checks during classwork. It can be especially heartbreaking for an LD student to finish an entire worksheet, only to be told that every answer is wrong and he’ll need to do it again. Instead, teachers should check after every problem, or every three or four. This way, children can learn from mistakes before moving forward.
  • List the steps for multi-step problems and algorithms. Post clearly numbered step-by-step instructions on the board, or give students a copy they can keep at their desk.
  • Keep sample problems on the board. Students should also copy them down in a notebook for reference.
  • Use individual dry-erase boards for students to work at their desks. Students can complete one step of a problem at a time, erasing any mistakes they may make.
  • Use plenty of brightly colored, uncluttered reference charts and diagrams.Children with dyscalculia benefit from visual representations of math problems whenever possible.
  • Whenever possible, allow calculator use. When testing more complex concepts than addition or subtraction, allow students to use calculators to make these basic steps quicker and more accessible. Then, students can focus on showing what they know — not how good they can add in their head.
  • Reduce the number of assigned problems. Assigning ten problems, rather than a full page, is enough to assess students’ understanding.
  • Avoid memory overload by assigning manageable amounts of practice work as skills are learned.
  • Build retention by providing review within a day or two of the initial learning of difficult skills.
  • Provide supervised practice to prevent students from practicing misconceptions and "misrules."
  • Reduce interference between concepts or applications of rules and strategies by separating practice opportunities until the discriminations between them are learned.
  • Make new learning meaningful by relating practice of subskills to the performance of the whole task, and by relating what the student has learned about mathematical relationships to what the student will learn next.
  • Reduce processing demands by preteaching component skills of algorithms and strategies.
  • Teach easier knowledge and skills before difficult ones.
  • Ensure that skills to be practiced can be completed independently with high levels of success.
  • Help students to visualize math problems by drawing.
  • Give extra time for students to process any visual information in a picture, chart, or graph.
  • Use visual and auditory examples.
  • Use real-life situations that make problems functional and applicable to everyday life.
  • Do math problems on graph paper to keep the numbers in line.
  • Use uncluttered worksheets to avoid too much visual information.
  • Use rhythm or music to help students memorize.
  • Use distributive practice: plenty of practice in small doses.
  • Use interactive and intensive practice with age- appropriate games as motivational materials.
  • Have students track their progress; which facts they have mastered and which remain to be learned.
  • Challenge critical thinking about real problems with problem-solving.
  • Use manipulatives and technology such as tape recorders or calculators.




What would be a goal for the IEP when you have Dyscalculia?

Goal writing is always a pain.  Is the goal SMART?  What's a good goal?  Often I struggle to come up with goals.  I found some help!

Common Core Aligned Goals for Kindergarten and First Grade

Virginia SMART goals (2009)

Goal and Objective Bank - Covers more than math

2nd and 3rd Grade Math Goals

Goal Bank (Tons of Goals for ALL Grades and Subjects)

2nd Grade Math Goals


What else can I do to help my child?


Embrace technology when your child has dysgraphia and/or dyscalculia!  There are great apps that can be used to help you and your child. Here are some apps/software you may find helpful:

Dyscalculia

ModMath

Math Cirriculum for Dyscalculia

Policy, Research, Identification and Intervention for Maths Learning Difficulties and Dyscalculia

 Math Programs and Apps for Dyscalculia

Dysgraphia 

http://www.augustafamily.com/


Dysgraphia is a specific learning disability that affects how easily children acquire written language and how well they use written language to express their thoughts. Dysgraphia is a Greek word. The base word graph refers both to the hand’s function in writing and to the letters formed by the hand. The prefix dys indicates that there is impairment. Graph refers to producing letter forms by hand. The suffix ia refers to having a condition. Thus, dysgraphia is the condition of impaired letter writing by hand, that is, disabled handwriting and sometimes spelling. Impaired handwriting can interfere with learning to spell words in writing. Occasionally, but not very often, children have just spelling problems and not handwriting or reading problems.




There are several different kinds of dysgraphia. Some people with dysgraphia have handwriting that is often illegible and shows irregular and inconsistent letter formations. Others write legibly, but very slowly and/or very small. When these individuals revert to printing, as they often do, their writing is often a random mixture of upper- and lowercase letters. In all cases of dysgraphia, writing requires inordinate amounts of energy, stamina, and time. Dysgraphia can interfere with a student’s ability to express ideas. Expressive writing requires a student to synchronize many mental functions at once: organization, memory, attention, motor skill, and various aspects of language ability. Automatic accurate handwriting is the foundation for this juggling act. In the complexity of remembering where to put the pencil and how to form each letter, a dysgraphic student forgets what he or she meant to express. Dysgraphia can cause low classroom productivity, incomplete homework assignments, and difficulty in focusing attention. Emotional factors arising from dysgraphia often exacerbate matters. At an early age, these students are asked to forego recess to finish copying material from the board, and are likely to be sent home at the end of the day with a sheaf of unfinished papers to be completed. They are asked to recopy their work but the second attempt is often no better than the first. Because they are often bright and good at reading, their failure to produce acceptable work is blamed on laziness or carelessness. The resulting anger and frustration can prevent their ever reaching their true potential.

Common symptoms of dysgraphia include:
The symptoms of dysgraphia fall into six categories: visual-spatial, fine motor, language processing, spelling/handwriting, grammar, and organization of language. A child may have dysgraphia if his writing skills lag behind those of his peers and he has at least some of these symptoms:

Visual-Spatial Difficulties
Has trouble with shape-discrimination and letter spacing
Has trouble organizing words on the page from left to right
Writes letters that go in all directions, and letters and words that run together on the page
Has a hard time writing on a line and inside margins
Has trouble reading maps, drawing or reproducing a shape
Copies text slowly

Fine Motor Difficulties
Has trouble holding a pencil correctly, tracing, cutting food, tying shoes, doing puzzles, texting and keyboarding
Is unable to use scissors well or to color inside the lines
Holds his wrist, arm, body or paper in an awkward position when writing

Language Processing Issues
Has trouble getting ideas down on paper quickly
Has trouble understanding the rules of games
Has a hard time following directions
Loses his train of thought

Spelling Issues/Handwriting Issues
Has a hard time understanding spelling rules
Has trouble telling if a word is misspelled
Can spell correctly orally but makes spelling errors in writing
Spells words incorrectly and in many different ways
Has trouble using spell-check—and when he does, he doesn’t recognize the correct word
Mixes upper- and lowercase letters
Blends printing and cursive
Has trouble reading his own writing
Avoids writing
Gets a tired or cramped handed when he writes
Erases a lot

Grammar and Usage Problems
Doesn’t know how to use punctuation
Overuses commas and mixes up verb tenses
Doesn’t start sentences with a capital letter
Doesn’t write in complete sentences but writes in a list format
Writes sentences that “run on forever”

Organization of Written Language
Has trouble telling a story and may start in the middle
Leaves out important facts and details, or provides too much information
Assumes others know what he’s talking about
Uses vague descriptions
Writes jumbled sentences
Never gets to the point, or makes the same point over and over
Is better at conveying ideas when speaking


Does Dysgraphia occur with other learning disabilities?
Children with impaired handwriting may also have attention-deficit disorder (ADHD)—inattentive, hyperactive, or combined inattentive and hyperactive subtypes. Children with this kind of dysgraphia may respond to a combination of explicit handwriting instruction plus stimulant medication, but appropriate diagnosis of ADHD by a qualified professional and monitoring of response to both instruction and medication are needed

Dysgraphia may occur alone or with dyslexia (impaired reading disability) or with oral and written language learning disability (OWL LD, also referred to as selective language impairment, SLI).

Dyslexia is a disorder that includes poor word reading, word decoding, oral reading fluency, and spelling. Children with dyslexia may have impaired orthographic and phonological coding and rapid automatic naming and switching. Phonological coding refers to coding sounds in spoken words in working memory. Phonological coding is necessary for developing phonological awareness—analyzing the sounds in spoken words that correspond to alphabet letters. If children have both dysgraphia and dyslexia, they may also have difficulty in planning sequential finger movements.

OWL LD (SLI) are disorders of language (morphology—word parts that mark meaning and grammar; syntax—structures for ordering words and understanding word functions; finding words in memory, and/or making inferences that go beyond what is stated in text). These disorders affect spoken as well as written language. Children with these language disorders may also exhibit the same writing and reading and related disorders as children with dysgraphia or dyslexia.

So what can be done to help a child with Dysgraphia?

There are many things that can done for remediation with dysgraphia.  Here is a list of possible accommodations and modifications:

Accommodations
  • When considering accommodating or modifying expectations to deal with dysgraphia, consider changes in
  • The rate of producing written work
  • The volume of the work to be produced
  • The complexity of the writing task
  • The tools used to produce the written product
  • The format of the product
  • Change the demands of writing rate
  • Allow more time for written tasks including note-taking, copying, and tests
  • Allow students to begin projects or assignments early
  • Include time in the student's schedule for being a 'library assistant' or 'office assistant' that could also be used for catching up or getting ahead on written work, or doing alternative activities related to the material being learned.
  • Encourage learning keyboarding skills to increase the speed and legibility of written work.
  • Have the student prepare assignment papers in advance with required headings (Name, Date, etc.), possibly using the template described below under "changes in complexity."
  • Adjust the volume
  • Instead of having the student write a complete set of notes, provide a partially completed outline so the student can fill in the details under major headings (or provide the details and have the student provide the headings).
  • Allow the student to dictate some assignments or tests (or parts of tests) a 'scribe'. Train the 'scribe' to write what the student says verbatim ("I'm going to be your secretary") and then allow the student to make changes, without assistance from the scribe.
  • Remove 'neatness' or 'spelling' (or both) as grading criteria for some assignments, or design assignments to be evaluated on specific parts of the writing process.
  • Allow abbreviations in some writing (such as b/c for because). Have the student develop a repertoire of abbreviations in a notebook. These will come in handy in future note-taking situations.
  • Reduce copying aspects of work; for example, in Math, provide a worksheet with the problems already on it instead of having the student copy the problems.
  • Change the complexity
  • Have a 'writing binder' option. This 3-ring binder could include:
  • A model of cursive or print letters on the inside cover (this is easier to refer to than one on the wall or blackboard).
  • A laminated template of the required format for written work. Make a cut-out where the name, date, and assignment would go and model it next to the cutout. Three-hole punch it and put it into the binder on top of the student's writing paper. Then the student can set up his paper and copy the heading information in the holes, then flip the template out of the way to finish the assignment. He can do this with worksheets, too.
  • Break writing into stages and teach students to do the same. Teach the stages of the writing process (brainstorming, drafting, editing, and proofreading, etc.). Consider grading these stages even on some 'one-sitting' written exercises, so that points are awarded on a short essay for brainstorming and a rough draft, as well as the final product. If writing is laborious, allow the student to make some editing marks rather than recopying the whole thing. On a computer, a student can make a rough draft, copy it, and then revise the copy, so that both the rough draft and final product can be evaluated without extra typing.
  • Do not count spelling on rough drafts or one-sitting assignments.
  • Encourage the student to use a spellchecker and to have someone else proofread his work, too. Speaking spellcheckers are recommended, especially if the student may not be able to recognize the correct word (headphones are usually included).
  • Change the tools
  • Allow the student to use cursive or manuscript, whichever is most legible
  • Consider teaching cursive earlier than would be expected, as some students find cursive easier to manage, and this will allow the student more time to learn it.
  • Encourage primary students to use paper with the raised lines to keep writing on the line.
  • Allow older students to use the line width of their choice. Keep in mind that some students use small writing to disguise its messiness or spelling, though.
  • Allow students to use paper or writing instruments of different colors.
  • Allow student to use graph paper for math, or to turn lined paper sideways, to help with lining up columns of numbers.
  • Allow the student to use the writing instrument that is most comfortable. Many students have difficulty writing with ballpoint pens, preferring pencils or pens which have more friction in contact with the paper. Mechanical pencils are very popular. Let the student find a 'favorite pen' or pencil (and then get more than one like that).
  • Have some fun grips available for everybody, no matter what the grade. Sometimes high school kids will enjoy the novelty of pencil grips or even big "primary pencils."
  • Word Processing should be an option for many reasons. Bear in mind that for many of these students, learning to use a word processor will be difficult for the same reasons that handwriting is difficult. There are some keyboarding instructional programs which address the needs of learning disabled students. Features may include teaching the keys alphabetically (instead of the "home row" sequence), or sensors to change the 'feel' of the D and K keys so that the student can find the right position kinesthetically.
  • Consider whether use of speech recognition software will be helpful. As with word processing, the same issues which make writing difficult can make learning to use speech recognition software difficult, especially if the student has reading or speech challenges. However, if the student and teacher are willing to invest time and effort in 'training' the software to the student's voice and learning to use it, the student can be freed from the motor processes of writing or keyboarding.

Modifications
  • For some students and situations, accommodations will be inadequate to remove the barriers that their writing problems pose. Here are some ways assignments can be modified without sacrificing learning.
  • Adjust the volume
  • Reduce the copying elements of assignments and tests. For example, if students are expected to 'answer in complete sentences that reflect the question,' have the student do this for three questions that you select, then answer the rest in phrases or words (or drawings). If students are expected to copy definitions, allow the student to shorten them or give him the definitions and have him highlight the important phrases and words or write an example or drawing of the word instead of copying the definition.
  • Reduce the length requirements on written assignments -- stress quality over quantity.
  • Change the complexity
  • Grade different assignments on individual parts of the writing process, so that for some assignments "spelling doesn't count," for others, grammar.
  • Develop cooperative writing projects where different students can take on roles such as the 'brainstormer,' 'organizer of information,' 'writer,' 'proofreader,' and 'illustrator.'
  • Provide extra structure and intermittent deadlines for long-term assignments. Help the student arrange for someone to coach him through the stages so that he doesn't get behind. Discuss with the student and parents the possibility of enforcing the due dates by working after school with the teacher in the event a deadline arrives and the work is not up-to-date.
  • Change the format
  • Offer the student an alternative project such as an oral report or visual project. Establish a rubric to define what you want the student to include. For instance, if the original assignment was a 3-page description of one aspect of the Roaring Twenties (record-breaking feats, the Harlem Renaissance, Prohibition, etc) you may want the written assignment to include:
    • A general description of that 'aspect' (with at least two details)
    • Four important people and their accomplishments
    • Four important events - when, where, who and what
    • Three good things and three bad things about the Roaring Twenties

What would be a goal for the IEP when you have Dysgraphia?

Back to that goal question again.  Sometimes they are so hard to come up with them on your own so I thought I would include some ideas.

IEP Goals for Writing , Keyboarding, and Copying

Did you know these were the only goal examples I could readily find.  If you find any others please let me know!

A little off topic but important to know...How to get the school OT to treat handwriting issues.
OT Services in the IEP: Handwriting

Apps to help those with Dysgraphia

SnapType

ScanWritr

DragonDictation

LetterSchool

Phorm


Information on Assistive Technology

General information on AT

Your Child’s Key to Great Writing: Assistive Technology for Dysgraphia and Writing Disabilities
Journal Article on Assistive Technology for Dysgraphia - June 2015


I hope you found this information useful.  This article was written mostly for the public school crowd but MANY of these ideas can be used and utilized by the homeschooling parent.  This article is littered with links!  Please click on all the links.  Some are used a reference to the material quoted in the article.  Other links are to items I found interesting but not specifically needed for this article. Please leave any comments or question you might have.  I will answer them as promptly as I can!


Wednesday, June 22, 2016

Lack of Effort or Slow Processing Speed?

Kids at the aquarium.  From Left to Right is
Joseph, James, and Margaret
Slow Processing Speed.  What the heck is that and what does it mean for my child???  I know I was wondering that same thing when Margaret and Joseph tested as having impaired processing speed.  James tested average on memory processing speed.  Margaret tested as impaired on the WISC-IV for memory processing speed and is a relative weakness for her.  Joseph's processing speed is significantly slower than his other neurocognitive abilities suggest which is not surprising since considering much of the processing speed depends on visual skills (Joseph is blind in one eye). With two kids have very impaired processing speeds I needed to find out what this means for me and for them.

What Impact Does Slow Processing Speed Create? 

Don’t automatically presume that the child is being oppositional, ‘lazy’, unmotivated, etc. because he/she takes longer to initiate or complete a task, or to respond to a task demand. Keep in mind the possibility that his/her behavior is the result of slow processing speed. Processing speed is the pace at which you take in information, make sense of it and begin to respond. This information can be visual, such as letters and numbers. It can also be auditory, such as spoken language. It is important to be alert to the possible emotional impacts that a child can experience in the face of slowed processing speed, and to provide emotional support and encouragement, as well as practical interventions.

Slow processing speed can cause negative impact to three main areas of someone's life. These are
Image courtesy of ilslearning.com
academic, social, and self-esteem. Academically, slow processing speed can lead to the following types of problems: slowed execution of easy academic tasks; slowed acquisition of new material; becoming overwhelmed by more complex academic demands; the need for extra time in responding to even well-practiced and automatic tasks; and difficulty making correct conceptual decisions quickly.

Socially, slow processing speed can lead to difficulty keeping up with normal give-and-take conversations among peers or with adults, or appearing to be ‘not-with-it’ by others, with the potential of being made fun of or mislabeled as a result.

With respect to self-esteem, the fallout from the problems described above can have a negative impact on self-esteem, leaving a child vulnerable to feelings of incompetence, self-consciousness, and/or depression. Many children with slow processing speed wrongly end up feeling that they are stupid, because they are aware that it takes them longer to get things done, or to understand some concepts.

Examples of slow processing speed, when a child with slow processing speed sees the letters that make up the word “house,” she may not immediately know what they say. She has to figure out what strategy to use to understand the meaning of the group of letters in front of her. It’s not that she can’t read. It’s just that a process that’s quick and automatic for other kids her age takes longer and requires more effort for her.

Saying too many things at once can also pose a challenge. If you give multiple-step directions—“When you come downstairs, bring your notebook. And can you also bring down the dirty glasses, and put them in the dishwasher?”—a child with slow processing speed may not follow all of them. Having slow processing speed makes it hard to digest all that information quickly enough to finish the task.

Slow processing speed impacts learning at all stages. It can make it harder for young children to master the basics of reading, writing and counting. And it impacts older kids’ ability to perform tasks quickly and accurately.

Slow Processing Speed, 2e, and ADHD


There is a newsletter for twice exceptional children (Gifted/2e) that has a WONDERFUL article on slow processing speed written in May 2013. In the article Steven Butnik, Ph.D outlines the issues with slow processing speed. It is common for gifted students to have slow processing speed.  Slow processing speed itself is not a disability.

Children with the predominantly inattentive subtype of ADHD may have a sluggish cognitive tempo. They typically daydream, stare off, and appear spacey. They may be mentally foggy, underactive, slow moving, and lethargic. Their work is often slow and error prone. Their brain activity shows patterns of under arousal in the portion of the brain associated with focus and planning.

In addition, children with ADHD typically exhibit poor executive functions, brain-based behaviors that contribute to effective functioning. (see my blog post on executive functioning) Executive functioning is often impaired in ADHD individuals.

Some children take more time to complete tasks due to trouble with activation. A student may not begin a task due to problems organizing time or materials, or due to reluctance, uncertainty, lack of confidence, or anxiety. Other children may take more time to complete tasks because of problems maintaining focus. While time is passing, these students may be distracted or daydreaming, drawn to other, more interesting stimuli.

Effort includes processing speed as well as mental stamina. When effort is a problem, the child’s work pace is very slow and he may complain that his “brain is very tired.” When the problem is emotional, on the other hand, children find it hard to regulate their feelings. They might melt down when starting to work or encountering a frustrating task; or they may refuse to work, be argumentative, or have tantrums.

Problems in working memory can add to the time it takes a child to complete tasks. After reading a paragraph, a child with poor working memory may forget what she just read and need to read it again; or he may stop working on a class assignment because he forgot the directions. Finally, when action is a problem, the child has trouble sitting still, fidgets with objects, or may want to stand or walk around when working.

An additional issue that children with ADHD face is having a poor sense of time. For them, time seems to go more slowly during the tasks they feel are boring while moving more quickly for tasks they find interesting. When planning work tasks, a child with ADHD may underestimate how long the task will take; and when playing, the child may be unaware of how much time has passed. Taken together, poor executive functions and poor time sense can make homework take hours to complete and create major stress.  Trust me on the stress!  Even homeschooling I can have issues with poor time management and starting work. I can only image if I sent my children to public school!  You can see in the image below how processing speed effects the effort (number 3) needed for executive functioning along with working memory (number 5). It is easy to see how executive functioning is impacted.
Image courtesy of 2enewsletter.com

How to Test for Slow Processing Speed? 

So how do we test processing speed?  I highly recommend in seeing a neuropsychologist. If you cannot then I suggest seeing a developmental pediatrician or pediatric psychologist.  In the executive function blog post I explain why.  If you need to the school to preform the testing then I highly suggest you tell the school you want testing in executive functioning, memory (working, long-term, and short-term), sustained attention, and processing speed. At public schools you cannot specify they use specific tests, but if they ask, tell then you want the Wechsler Intelligence Scale for Children ® - Fourth Edition (WISC ® -IV).

Who can administer this test?

Tests with this qualification require a high level of expertise in test interpretation, and can be conducted by individuals with:

  • A doctorate degree in psychology, education, or closely related field with formal training in the ethical administration, scoring, and interpretation of clinical assessments related to the intended use of the assessment.
  • OR
  • Licensure or certification to practice in your state in a field related to the purchase of the test.
  • OR
  • Certification by or full active membership in a professional organization (such as APA, NASP, NAN, INS) that requires training and experience in the relevant area of assessment.

More Information and Training on Score Reading

On WISC-IV's on page, at the bottom of the page next to the product details tab, there are a couple of other great tabs you may want to research.  Under the Resource tab there are several technical reports.  A couple that caught my eye included Technical Report #6: Using the Cognitive Proficiency Index in Psychoeducational Assessment and Technical Report #5:WISC–IV and Children’s Memory Scale, and Technical Report #2: Psychometric Properties.  There are also some training on WISC-IV Interpretation & WISC-IV Integration along with a training on advanced topics of WISC-IV.  Don't forget to peek at the FAQ tab while you are there. There is also a Processing Speed Damian Case Study that has been produced.  I think it provides wonderful information if you are curious to see if your child has processing issues.


So how do we read the WISC-IV report?

This gets a bit more technical.  Please ask questions in the comment section and I will try to answer them as best as I can considering this is NOT my area of expertise (I am not a psychologist nor have I had training). 

Processing speed is an element of intelligence, as measured by many tests of cognitive ability, including the Wechsler Intelligence Scale for Children (4th Edition). Scores for both the Working Memory and Processing Speed subtests make up the WISC-IV’s Cognitive Proficiency Index. These abilities are separate from the WISC-IV’s General Abilities Index, a measure of core intelligence derived from an individual’s Verbal Comprehension and Perceptual Reasoning Indices (verbal and nonverbal abilities).


Each of these three subtests taps different abilities that contribute to the Processing Speed score. 
  • Coding, which requires children to draw symbols, is heavily influenced by grapho-motor demands. Children with poor handwriting or dysgraphia may struggle with this task. 
  • Symbol Search has less emphasis on motor output but requires rapid differentiation of abstract symbols. 
  • Cancellation, the supplemental Processing Speed subtest, makes use of concrete images rather than symbols.
According to Steven M. Butnik, Ph. D., LCP, the Processing Speed subtest assesses the abilities to focus attention and quickly scan, discriminate between, and sequentially order visual information. It requires persistence and planning ability, but is sensitive to motivation, difficulty working under a time pressure, and motor coordination. It is related to reading performance and development. It is related to Working Memory, in that increased processing speed can decrease the load placed on working memory, while decreased processing speed can impair the effectiveness of Working Memory.
The Working Memory subtest assesses the ability to hold new information in short-term memory, concentrate, and manipulate that information to produce some result or reasoning processes. It is important in higher-order thinking, learning, and achievement. It can tap concentration, planning ability, cognitive flexibility, and sequencing skill, but is sensitive to anxiety too. It is an important component of learning and achievement, and ability to self-monitor. 

Tests of educational achievements make use of processing speed on subtests that measure academic fluency. For example, the Woodcock-Johnson Tests of Achievement include three subtests of fluency:
  • Reading Fluency. For three minutes the student quickly reads simple sentences and answers yes or no to each.
  • Writing Fluency. Using three words and a picture, the student quickly writes simple sentences for seven minutes.
  • Math Fluency. The student rapidly performs simple calculations for three minutes.
Children who have trouble activating, are inattentive, or have sluggish cognitive tempo may struggle on all of these tasks. Children with slow motor output would have less trouble on Reading Fluency but would do more poorly on the Math and Writing Fluency tests. Working memory problems would likely have a greater impact on Math Fluency than on the other fluency tasks.

A subset of children with reading disorders display marked difficulties with verbal and visual processing speed and that may indicate a subtype of reading disorder. Individuals with impairments in both RAN (rapid automatic naming) and phonemic awareness had the most severe reading problems when matched on phonological skills. Individuals with worse RAN scores had poorer performance on timed word recognition and comprehension tests.

Other tests that measure Processing Speed and Working Memory

So there are other tests that measure processing speed and working memory. Other tests that may be used at the school include the Woodcock-Johnson Tests of AchievementWechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) and the Wechsler Preschool and Primary Scale of Intelligence™ - Fourth Edition (WPPSI™ - IV). The last test , the WPPSI, is for children ages 2.5 years to about 7.5 years old. Each of these tests have components that can measure processing speed.

The Woodcock Johnson IV can measure cognitive processing speed and working memory. 
Cognitive Processing Speed is the ability to quickly perform both simple and complex cognitive tasks, particularly when measured under pressure to sustain controlled attention and concentration. This cluster includes Letter-Pattern Matching (locating and circling two identical letter patterns in a row of 6 patterns) and Pair Cancellation (locating and marking a repeated pattern as quickly as possible). 

In the WJ-IV the short-term memory subset measures the ability to capture and hold information in immediate awareness and then use it or manipulate it to carry out a goal. This cluster includes Verbal Attention (answering specific sequence questions when provided with a series of animals and digits from an audio recording) and Numbers Reversed (holding a span of numbers in immediate awareness while performing a mental operation on it).

Image courtsy of CultofPedagogy

Processing Speed's Impact on Learning and Emotional Issues

Slow processing speed is not a learning disorder. To be considered to have a learning disorder, a student must have the following:
  • Average or better intelligence
  • Patterns of substantial processing differences
  • A significant difference between abilities and achievements.
However, research has shown that processing speed is linked to reading development and reading performance. Specifically, processing speed may be a factor in these situations:
  • Reading disorders such as dyslexia
  • A subset of reading disorders in which individuals display marked difficulties with verbal and visual processing speed
  • Grapho-motor problems (dysgraphia). Individuals with dysgraphia have serious trouble forming letters and numbers; their handwriting is slow and labored; they may have trouble with spacing between words; they mix upper- and lower-case letters; etc. Because neatness only comes with their taking much time, their written work can be very strained and painful.
So what does slow processing speed look like?  Kids might have trouble with:
  • Finishing tests in the allotted time
  • Finishing homework in the expected time frame
  • Listening or taking notes when a teacher is speaking
  • Reading and taking notes
  • Solving simple math problems in their head
  • Completing multi-step math problems in the allotted time
  • Doing written projects that require details and complex thoughts
  • Keeping up with conversations
Image courtesy of sideshare.net

Parents and teachers may notice that a child:
  • Becomes overwhelmed by too much information at once
  • Needs more time to make decisions or give answers
  • Needs to read information more than once for comprehension
  • Misses nuances in conversation
  • Recognize simple visual patterns and in visual scanning tasks
  • Take tests that require simple decision making
  • Perform basic arithmetic calculations and in manipulating numbers, since these operations are not automatic for them
  • Perform reasoning tasks under time pressure
  • Make decisions that require understanding of the material presented
  • Read silently for comprehension
  • Copy words or sentences correctly or to formulate and write passages
  • Has trouble executing instructions if told to do more than one thing at once
Some key things to note:
  • Slow processing speed can affect the ability to make decisions quickly.
  • Trouble with processing speed can affect a child’s executive functioning skills.
  • Having your child evaluated can reveal problems with processing speed.

So what can I do to help my child learn?

INSTRUCTIONAL STRATEGIES:
The key instructional strategy for students with slow processing speed is to reduce the time pressure associated with a task. This can be done in three essential ways:

  • Give the student more time for their work
  • Allow longer response time for the student to respond orally to questions in class
  • Complete seatwork assignments in class
  • Allow suficient time to make decisions when offered a choice of activities
  • Allow extra time for tests, usually time and a half
  • Provide extra time for the student to complete in-class assignments
  • Develop keybording skills
  • During writing intensive exercises allow the use of a computer or other word processor
  • Reduce the amount of work the student is required to do.
  • Shorten the assignment so it can be accomplished within the time allotted
  • Focus on quality of productions, rather than quantity
  • Shorten drill and practice assignments that have a written component by requiring fewer repetitions of each concept
  • Provide copies of notes rather than requiring the student to copy from the board in a limited time
  • Allow student to answer orally for written tests and other assignments when possible
  • Provide direct and explicit instruction in strategic problem solving, reading fluency, and organizational strategies
    • I haven't read it but it looks interesting.
    • For example, teach him how to use graphic organizers to plan writing assignments or to enhance reading comprehension. Help him improve his visual imagery so as to support visual working memory, and show him how to use mnemonics such as acronyms, acrostics, and pegwords to learn new information.
Build the student’s efficiency in completing work through building automaticity.
  • Provide instruction to increase the student’s reading speed by training reading fluency, ability to recognize common letter sequences automatically that are used in print; and sight vocabulary
  • Provide timed activities to build speed and automaticity with basic skills, such as:
    reading a list of high-frequency words as fast as possible and calculating simple math facts as fast as possible
  • learning simple math calculations through flash cards, educational software exercises, and music
  • charting daily performance for speed and accuracy
Train the student in time management techniques to become aware of the time that tasks take.
  • Teach the student to use a stopwatch or to record his or her start and end times for assignments to monitor the time spent on each activity. Set a goal for the student to gradually reduce the time needed to do these tasks.
ASSESSMENT STRATEGIES:
Assessment strategies emphasize power tests that focus on the knowledge the student has, rather than on speed tests to complete a large number of questions within a limited time.
  • Emphasize accuracy rather than speed in evaluating the student in all subject areas
  • Replace timed tests with alternative assessment procedures
  • Allow extra time for tests and exams. Give the student supervised breaks during the test
  • Provide a reader or text-to-voice software to read test questions to the student to accommodate for slow reading fluency
  • Provide a scribe or voice-to-text software to record the student’s answers on tests to accommodate for slow writing fluency
  • Use test formats with reduced written output formats (e.g. multiple choice, True / False, fill in the blank) to accommodate for slow writing fluency

I hope you have found this blog post helpful.  I know it was for me in researching and writing it.  I learned a lot about myself and a lot about my children.  Please feel free to leave comments including any questions or concerns.  I will answer to the best of my ability.