Milton J. Dehn, Ed.D., NCSP Schoolhouse Educational Services May, 2013 Identifying a Pattern of Strengths and Weaknesses when Assessing Cognitive Processes Milton J. Dehn, Ed.D., NCSP Schoolhouse Educational Services May, 2013

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Workshop Information Sources Essentials of Processing Assessment, 2nd Ed. Children’s Psychological Processes Scale Bibliography in handout Other cited references www.psychprocesses.com

Workshop Topics Processes to assess Processes and academic skills Neuroanatomy of processes Selective, cross-battery testing Identifying strengths and weaknesses SLD identification using a pattern of strengths and weaknesses Overview of processing interventions

What are Psychological Processes? Includes “cognitive” processes Brain processes, operations, functions Any time mental contents are operated on When information is perceived, transformed, manipulated, stored, retrieved, expressed Whenever we think, reason, problem-solve Basic and higher level processes Doesn’t include knowledge or academic skills Learning depends on these processes; they underlie academic skills

The Need for Processing Assessment Part of a neuropsychological approach Not just for SLD but Autism, ADHD, TBI, etc. Neuroscience has increased understanding of brain-learning relationships A deficit in a “psychological process” is part of federal and states’ SLD definitions Identification leads to more appropriate interventions

Federal & State SLD Criteria SLD is…… “a disorder in one or more of the basic psychological processes” IDEIA 2004 allows alternative research-based procedures (the third method) Been interpreted as allowing use of a pattern of strengths and weaknesses (PSW) in SLD diagnosis In achievement, cognitive abilities, or psychological processes

Processing Assessment Advantages Benefits the learner: better understanding Identifying a processing deficit differentiates SLD & slow learning Identifying processing deficits provides direction for academic interventions

Processing and RTI Processing model consistent with problem-solving and early intervention There are evidence-based processing interventions Different processing “causes” of SLD Why do “blind” academic interventions Processing & academic interventions compatible---why they work

Characteristics of Psychological Processes to Assess Brain-based Interrelated Necessary for academic learning Both broad and narrow processes Manifestations of processing problems are observable in classroom

Processes for SLD Assessment Attention Auditory Processing Executive Functions Fine Motor Fluid Reasoning Long-Term Recall Oral Language Phonological Processing Processing Speed Visual-Spatial Processing Working Memory (WM)

Human Processing Limitations Human limitations Which processes does the chimp excel at?

Attention Necessary for learning and memory Attention deficits part of LD Not necessarily ADHD ADHD is more hyperactive/impulsive Inattentive type is more cognitive/learning problems Types: Selective, focused, divided, sustained Problem: attentional control & inhibition Related to Executive Functions and Working Memory

Auditory Processing Ability to perceive, analyze, synthesize, and discriminate auditory stimuli, mainly speech Perceiving and comprehending instruction; being able to understand words with background noise

Executive Functions Management of cognitive functions and psychological processes Effectiveness depends on self-monitoring, self-regulation, and metacognition Has a longer course of development More to do with classroom performance than learning of academic skills

Fluid Reasoning Deductive, inductive reasoning, especially with novel materials Has a longer course of development More important for applied academics

Long-Term Recall Close connection with other processes and with academic learning in general Includes encoding, consolidation, storage, and retrieval Rapid automatic naming is part of

Oral Language Not the content (vocabulary) or receptive language but the oral expression processes

Phonological Processing Processing of phonemes, e.g. blending Phonemic awareness is part of

Processing Speed How quickly information flows through the processing system; a matter of efficiency Too slow: info. lost, process not completed

Visual-Spatial Processing The ability to perceive, analyze, synthesize, manipulate and think with visual patterns A strength in most LD cases Weak relations with all academics; more of a “threshold” process

Working Memory Processing while retaining information Includes short-term memory Both verbal and visual An executive component

Processes and Academic Learning Psychological processes are like “aptitudes” Relations established through research Flanagan et al., & McGrew Swanson, Geary, and others The influence of processes varies by age For SLD look for academic area and related psychological processes to both be low See Table

Research: SLD by Processing Subtypes Visual-Spatial Deficits: Math calculation and math problem solving Processing Speed Deficits: Reading comprehension, written expression Working Memory Deficit: Math calculation, Written expression Attention: Written expression Source: Hain, Hale, Kendorski

Dehn’s Processing Theory “For each academic skill there is an optimal set of psychological processes that function as aptitudes. For successful learning of a specific academic skill, the combined set of specific aptitudes must attain a sufficient threshold of development.” Link

Processing Clusters: Memory Example Attention Executive Functions Fluid Reasoning Long-Term Recall Processing Speed Working Memory See Link for other clusters

Developmental Groupings Mature early after gradual development: Auditory Processing Fine Motor Processing Long-Term Recall Phonological Processing Visual-Spatial Processing See link for other groupings

Neuroanatomy of Processes

Neuroanatomy of Processes Most in more than one brain lobe Illustrates the interconnectivity of processes Most have specific structures within a lobe Processing speed is a function of interconnectivity; does not have a specific structure

Occipital Lobe Dedicated to vision and visual-spatial processing Receives sensory data from the thalamus Visual and spatial processing are separate Dorsal stream (upper) sends spatial information to parietal lobe Ventral stream (lower) sends visual information to temporal lobe

Temporal Lobe Auditory processing Long-term memory processing in the hippocampus Some visual processing Semantic memory storage

Parietal Lobe Integrates sensory information Language processing Phonological processing

Frontal Lobe The “output” lobe; others are input Executive functions---prefrontal cortex Working memory---prefrontal cortex Attentional control---prefrontal cortex Fluid reasoning Fine motor Oral expression No storage of long-term memories

Processing Assessment Challenges Connecting to academic concerns Interrelated processes Not all are found in one convenient battery Doing it efficiently Linking with interventions

Processing Assessment Principles Should be multimethod, multisource, and multisetting Informal, qualitative not enough Should include standardized testing Should be hypothesis driven Selective, cross-battery testing Integrate data during interpretation

Records Review Any medical or health conditions Age of onset Developmental delays Look for reported behaviors that indicate processing problems Difficulty memorizing arithmetic facts: WM Difficulty blending: Phonological processing Low fluency: Processing speed

Interviews Ask directly about processes but also ask about behaviors that are manifestations of processing weaknesses Teachers: Ask about their hypotheses Parents: Home environment examples Students: Middle school and older Suggested teacher and parent interview items will be in revised book

Observations An observed behavior is due to more than one process Look for several problematic behaviors that go with a specific process See link

Dehn’s Approach to Cross Battery Not limited to CHC factors “Narrow” abilities/processes included Includes processing factors that are important for learning of academic skills Includes rating scales Subtests classified through task analysis Analyze scores at the composite (two-subtest) level whenever possible

Cross-Battery Testing Assessment driven by hypotheses Mix scales/batteries to cover all the areas Try to limit the number of scales Should be normed about the same time Avoid redundancies when testing Ideally, 2 subtests per process Analyze results together and use a cross-battery mean to determine discrepancies

Selective Testing Test all processes important for academics With most attention to an in-depth assessment of hypothesized weaknesses Apply a cross-battery approach Pick composites first Categorized by factor and task analysis See selective testing tables Link See comprehensive list link from book

Hypothesis Testing Approach Given academic deficiency, what are the most likely process deficits It’s “why” the child has a learning problem Include non-processes Must collect assessment data to “test” hypotheses Try to avoid “confirmatory bias” We all have weaknesses

Planning a Processing Assessment Complete the processing assessment planner Template Completed example See case study

Six-Year Old Case Study Concerns Learning colors, letters, and numbers Inconsistent performance Recognizing and generating rhyming words Reading learning difficulties Doesn’t remember directions Difficulty getting started on a task Word retrieval problems Math learning difficulties

Processing Analysis Worksheet Composite scores from test manual when possible Convert all scores to standard scores Exclude non-processing factors and subtests Compute clinical process scores by averaging Compute processing mean Calculate discrepancies Determine weaknesses and deficits Do pairwise comparisons Completed Example Opposites and those closely related Complete worksheet and interpret

Using Dehn’s Processing Analysis Worksheet to Determine PSW Deficit = both normative and intra-individual weakness (deficit is a “strong” weakness) Scores below 90 are normative weaknesses Below 85 if not using deficit approach Intra-individual strengths and weaknesses use 12 point discrepancy Assumes composites/subtests have hi reliability Use 15 points if not using deficit approach Automated worksheet

PSW Principles Regarding SLD Neurologically-based deficits underlie SLD There’s no SLD if there’s no processing deficit Some processes highly related with academic skills Processing deficits related to academic deficits SLD have average or near average cognitive ability Weakness should be normative &intra-individual Weakness: statistically significant and unusual PSW doesn’t mean there is a learning disability.

Concordance-Discordance Model From James Brad Hale Link Similar to Naglieri’s model Processing areas not significantly related to the academic area should be discordant: Processing strengths should be significantly higher than the academic weakness

CHC Model A process related to the academic deficiency is weak or deficient Unexpected underachievement: Process and academic deficit exist with otherwise normal ability Regarding strengths, at least some processes should be in the average range

Dehn’s PSW Model Normative weakness + intra-individual weakness = deficit At least one process is a deficit Intra-individual weakness is statistically significant Subtest scores must be unitary for a deficit At least one processes is in average range (strength) The deficit is related to deficient academic skill Consistency between process score(s) and the related academic skill score Link

Determining Weaknesses & Deficits Intra-individual strengths and weaknesses Should be at least a 12-point discrepancy 15 points if not using deficit rule Normative weakness when score below 90 Deficits are rare statistically, have a neurological basis, and impair learning Most states require only a weakness (typically an intra-individual weakness) but not a deficit, and also require strengths

Support for Strengths and Weaknesses Informal data supports test scores and results of score analysis Corroboration especially needed when scores differences are less than one standard deviation (12-14 points) Integrate and label data when writing report Weaknesses match with specific academic areas they are highly related with

Psychological Processing Analyzer Available at www.psychprocesses.com Identifies strengths, weaknesses, deficits Conducts cross-battery analysis using composites and/or subtest standard scores 11 psychological processes From 22+ different scales: cognitive, achieve., rating, and processing link

Psychological Processing Analyzer Composite and subtests are limited to those that are fairly direct measures Some are re-classified based on the primary demands of the task Difference formulas based on reliability coefficients of composites/subtests Regression toward the mean .01 or .05 level of significance

Psychological Processing Analyzer All scores converted to standard scores Non-unitary process scores are flagged Predicted score for each process based on mean of other 10 Differences greater than critical values are intra-individual weaknesses Deficits are both types of weaknesses Pairwise comparisons are optional Link

Other Options for Determining PSW Cross-battery software based on CHC taxonomy Only shows one process weakness at a time Use simple difference (SED) formula Uses reliability coefficients Advanced formula can be used when correlation between measures is known Checking for confidence interval overlap

Rating Scales Processing deficits are manifested through behaviors Behavior ratings can be used to measure processing abilities Examples: BRIEF and other Executive Function Scales Also, the new CPPS

Children’s Psychological Processes Scale (CPPS) Overview Standardized teacher rating scale Ages 5-0-0 to 12-11-30 121 items across 11 subscales Entirely online, internet-web based Online administration time of 15 minutes Online scoring and report Author: Milton Dehn; published by Schoolhouse Educational Services, 2012 Measurement Consultant: Kevin McGrew

The Purposes of the CPPS SLD Evaluations Identify psych processing deficits Pattern of strengths and weaknesses Data for SLD diagnosis Screening Identifies need for intervention Predicts academic skills development Useful in planning comprehensive assessment Planning interventions Measure progress during interventions Through the use of change-sensitive W-scores

CPPS Standardization 1,121 students rated by 278 teachers 128 communities in 30 states All data collected online Demographics match U.S. Census well Norms: 4 age groups (5-6; 7-8; 9-10; 11-12) Included children with disabilities Demographics details Link

How The Online CPPS Works A psychologist’s side and a teacher’s side Psychologist fills in teacher information and email sent Teacher: student info and completes ratings Psych receives email stating ratings complete Psych generates report See screen shots

CPPS Administration Online rating scale 12-15 minutes for teachers to complete Can print free paper copy and enter later Must answer all items (but can save incomplete) Never, Sometimes, Often, Almost Always Rating scale saved until report generated

CPPS Items Grouped by subscale In developmental (ability) order from lowest item to highest item Link Example of scoring in developmental sequence Link

CPPS Report Brief narrative, graph, and a table of scores Change-sensitive W-scores T-scores; percentiles; confidence intervals Intra-individual strengths and weakness discrepancy table T-score to standard score converter Can be re-run with different options (without extra charge) Example

Discrepancy Analysis Use discrepancy table to determine pattern of strengths and weaknesses (reversed) Predicted score based on mean of other 10 Regression toward the mean included +/- 1.00 to 2.00 SD of SEE discrepancy options Strengths and Weakness labeling is opposite of discrepancy, e.g. “-” value = a strength Non LD also have a pattern Link

T-Score Conversion Table Optional Purpose: To see how consistent CPPS scores are with achievement and cognitive scores T-score x 1.5 + 25 and then reverse distance from mean Example: T-score of 60 x 1.5 = 90 + 25 = 115 Then subtract 15 from 100 = 85 Example

CPPS General Processing Ability (GPA) Based on average of all process scores Emerges from factor analysis; similar to concept of general intelligence Processes function in an inter-related fashion Most processes contribute to any given behavior, task On CPPS defined as “the underlying efficiency of processing”

Diagnostic Accuracy for LD 37 LD subjects with broad demographics Compared to matched controls, LD subjects had significantly higher means on all subscales Link The CPPS had high classification accuracy in regards to LD Using CPPS GPA cutoff of 60 had a 92% classification accuracy across 74 subjects

Diagnosing LD with the CPPS Look for pattern of strengths and weaknesses (discrepancy table) Weaknesses should also be normative weaknesses (T-scores above 60) Weaknesses should link to evidence-based achievement relations Same criteria as PSW model

Discussion How will you do processing assessment differently? How will you determine weaknesses, strengths, deficits?

Using Assessment Results to Plan an Intervention Select deficits and intra-individual weaknesses for intervention Consider related processing weaknesses Consider executive and WM limitations Individualize

Interventions for Processing Weaknesses & Deficits Strengthen weakness if possible And utilize the strong areas more Modifications that reduce the need to use the weak processes Use methods that involve other processes, more of the brain

Attention: Self-Monitoring Teacher, or device carried by student, cues student at variable intervals, such as 5 minutes When cued, student marks monitoring sheet regarding behavior when cue occurred: 2-Completely on task; 1-Partially on task; 0-Completely off task When teacher is cueing, she also provides her rating alongside student’s; student receives bonus point when ratings match Set a points goal that student is working for, easy at first, then keep adjusting upward Link

Auditory Processing Same as interventions for CAPD Recoding auditory into visual information Visual representations should accompany verbal presentations Quiet environment Improve acoustics Fast ForWord Auditory trainers (individual sound systems)

Executive Function Increase metacognitive awareness Teach planning Work completion: set goal and time

Planning Developing planning improves math performance Discuss benefits of plans Develop plans Verbalize them Implement them and evaluate

Fine Motor Occupational therapy Handwriting practice

Fluid Reasoning Problem solving Categorizing Similarities and differences Games that require reasoning and recognizing relationships

Long-Term Recall Dual encoding Elaboration Testing Visual mnemonics Retrieval Distributed practice Context cues

Oral Language Closure procedures Categorizing words Create a variety of sentences using same words Synonyms and antonyms Paraphrasing Language therapy

Phonological Processing Phonemic awareness interventions very effective .86 effect size (the earlier the better) Oral at first, then with written material Rhyming; isolating phonemes; identifying phonemes; deleting phonemes; categorizing common phonemes; segmenting phonemes that comprise words; and blending phonemes into words

Processing Speed Video Games

Visual-Spatial Processing None recommended

WM: Reducing Cognitive Load Brief, consistent verbalizations One process at a time Allow time for rehearsal and processing Quiet learning environment Organized presentations One step at time Worked examples Partially completed problems

WM: Teach Rehearsal Most have by age 10; 1st graders can learn Serial and cumulative repetitive process Repeat first word until next delivered then add next word to the repetition First aloud, then subvocal Good maintenance if overlearned Increase length of list More effective than elaborate strategies?

WM Accommodations Extended testing time Repeating information Repeating information in a simplified manner Providing written checklists and reminders of step-by-step procedures One task at a time Slow down presentation Preferential seating to reduce distraction Provide prompts and cues

N-Back Task (Exec. WM) Challenging task but easily administered Shown to improve WM capacity Remember stimulus n-items back Do it repetitively Deck of cards ideal; prevents practice effects Parents and children can practice at home n-back task What strategy would you teach the child for succeeding at this?

N-Back Procedures Display cards one at a time for 1-2 seconds Start over after 1st error Should get 10 consecutive correct 3 times before going to next N 10-15 minutes of daily practice for 4 weeks More challenging: A double n-back Establish baseline Encourage strategy use

Using Math to Build WM Complete calculations Remember the answers in sequence 4 + 3 = 7 9 – 3 = 6 Response: 7, 6

Discussion How will you attempt to incorporate processing interventions into IEP or other intervention programs?