Characteristics of Disabilities SPED 576 Jessica Hovland & Kary Zarate Welcome to the lecture on Characteristics of disabilities.

Disabilities Learning Disabilities: Reading, Writing, Mathematics Attention Deficit Hyperactivity Disorder (ADHD) Emotional Disorders Gifted and Twice Exceptional Researching In this lecture we will will discuss several types of disabilities that are most common in schools and educational clinics. We will also discuss how to independently research more on your own cases.

Patterns are Important! Look for patterns in performance across assessments Error analysis – are the same errors made on multiple tests? Strengths – what does the child consistently do well? Ease of task completion – did the child complete the task quickly and easily? Look for similarities in behavior and performance across settings Home School and different classrooms within school Clinic When considering a disability, it is important to look for patterns. It is important to remember that these are only a piece of the puzzle. A key question to consider is whether the performance we see in the work samples, test item analysis, and throughout behavioral observations are consistent across different assessments. You’ll want to notice through:

Learning Disabilities The new DSM-5 now suggests an overall diagnosis of specific learning disorder, rather than a more specific definition of, for example, dyslexia or dyscalculia. Although we will not be diagnosing learning disabilities in the clinic, it is important for special educators to be familiar with how clinicians define learning disabilities. Most likely, as a special education teacher, you will be part of the team that determines whether a child is eligible for special education services under IDEA for a learning disability. Due to the broad, often misunderstood nature of learning disabilities, you should be familiar with the criteria before participation in an eligibility meeting. IDEA defines a learning disability as “…a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in an imperfect ability to listen, think, speak, read, write, spell, or do mathematical calculations…” Academic achievement should be below average in the area of disability, while other achievement areas should be average or above average. Typically, a child will not qualify for special education services unless they are doing poorly in school and below average for their grade level. However, this does not mean that there is not a deficit present and we will still recommend interventions as appropriate. Retrieved from: http://www.dsm5.org/Documents/Specific%20Learning%20Disorder%20Fact%20Sheet.pdf

Things to Rule Out for a Learning Disability Cultural-linguistic differences Noncognitive factors (e.g. motivational issues, emotional disorder, trauma) Intellectual disability Sensory/health impairment Lack of instruction If you suspect a learning disability and/or are evaluating for the presence of one, it is imperative that other causes of learning difficulties be ruled out. This list is based on federal law and should be relatively similar no matter where you teach. A pattern of low scores across cognitive and achievement batteries may be suggestive of more general cognitive impairment/delay rather than a specific learning disability. It is also necessary to ensure adequate hearing and vision, as these can cause difficulties with academics as well. For example, if a child has needed glasses for five years, and only recently had their vision corrected, this may have resulted in missed instruction. In this case, the child doesn’t necessarily have a disability, but does need intervention to catch-up to grade level/peers. In our clinic, a lack of instruction is difficult to determine. However, if the child has good school attendance and has not moved around much, there is no reason to believe they were not given adequate instruction. Similarly, different stressors in a child’s life may affect their learning, but not necessarily be caused by a disability. Moving or the divorce of parents can be significant stressors for children and may cause anxiety that impacts attention and processing, and therefore learning. One of my former students experienced a significant setback in her writing performance after the death of her father. Her grief and depression contributed to very poor academic performance, and it took almost an entire school year before she could write well on her own again. Reference: Christo, C., Davis, J.M., Brock, S.E. (2009). Identifying, assessing, and treating dyslexia at school. In Developmental Psychopathology at School.

Reading Disability: Word-level Often referred to as dyslexia Difficulties with: phonological processing, rapid naming, working memory, language Weaknesses in reading, but no overall language delay Link between cognitive ability area and academic achievement (e.g. phonological processing and difficulty sounding out words) Difficulties with accurate/fluent word recognition Poor spelling and decoding abilities Comprehension difficulties secondary to word-level difficulties Next we will discuss several types of learning disabilities: in the next few slides we will focus on the different kinds of reading disabilities. This first one is word-level reading disabiltity. The words dyslexia is very misleading; if you break the word apart Dys is an english prefix meaning diffuclty and lexia as a greek root means spech and in latin mean to read. Dyslexia is a language based learning disability. It refers to a cluster of symptoms which results in individuals having difficulties with specific language skills, particularly reading. It is a myth the people with dyslexia read backwards-- Reading Disability: Word-level Reference: Christo, C., Davis, J.M., Brock, S.E. (2009). Identifying, assessing, and treating dyslexia at school. In Developmental Psychopathology at School.

Reading Disability: Word-level Children being evaluated in late elementary school or middle school may: Read slower than expected Have poor spelling Have poor handwriting Have difficulty with new, technical vocabulary Struggle to learn a foreign language Children with strong vocabulary skills and strong memories may be able to compensate for difficulties in reading in the early elementary years. These children may begin to struggle in the late elementary years, when instruction shifts from learning to read to reading to learn. More difficult vocabulary in science and social studies may present new challenges. As demands in writing increase, these children may experience more difficulty with written expression tasks. Results of spelling tests (encoding) may reveal that a child has knowledge of phonics rules, but has difficulty applying them. This could be due to poor word representations in their mental lexicon. (See Can You Read This? Example) Reading Disability: Word-level Can You Read This? Anewun kan lurn if thay nothe rite stradijy. Reference: Christo, C., Davis, J.M., Brock, S.E. (2009). Identifying, assessing, and treating dyslexia at school. In Developmental Psychopathology at School.

Reading Disability: Comprehension Often referred to as hyperlexia Scores on standardized tests show deficits in comprehension despite average to above average scores in reading accuracy May have deficits in oral language skills Difficulty with working memory, accessing prior knowledge, and identifying relevant information in a text Difficulty with organization information, making inferences, and comprehension monitoring Reading comprehension difficulties, sometimes referred to as hyperlexia, are less well studied than dyslexia. Reference: Hulme, C. & Snowling, M.J. Developmental Disorders of Language, Learning and Cognition.

Characteristics of dysgraphia, or challenges with the physical act of writing, include: Inconsistencies in letter formation and spacing Illegible writing despite adequate time Talking to self while writing Watching hand while writing Slow copying Omitted words Cramped, unusual grip Writing Disability In the next few slides we will discuss writing disabilities. A specific learning disability in writing is typically referred to as dysgraphia: or or challenges with the physical act of writing, include: Some students with ADHD significantly struggle with organizing their thoughts and writing a coherent essay. Writing requires attention to multiple things at one (spelling, grammar, punctuation, paragraph structure, forming letters/holding a writing utensil, organizing thoughts into sentences, adding higher level thoughts and creativity). If any of these pieces is not automatic, it can make writing very frustrating. Additionally, it is not uncommon for children with ADHD to also have a learning disability. In fact, many students with ADHD struggle with writing because of the organizational and attention demands placed on them during the task of writing. Some students may thrive with creative writing, where they are not bound by the structures of formal essays, but then significantly struggle with persuasive or expository essays. Can be due to a learning disability or ADHD Writing is a very complex cognitive process & can be affected by many things

Writing Disability Writing, especially spelling, is a process that is closely tied with reading. If a child particularly struggles with the spelling component of writing, it may be linked with a reading disability. Look at this example, what do you notice? The student has knowledge of phonics, but poor mental lexicon; writes slowly and has inconsistent spacing) Writing can also be affected by deficits in oral language, attention, and memory. Often times, students with LD lack the strategies needed to plan and execute a writing task.

Characteristics of difficulties with written expression: Problems generating text Produce shorter, less interesting writing Poorly organized sentences and paragraphs Less likely to proof-read for spelling, punctuation, and grammar Less likely to use strategies Less likely to revise writing for clarity Writing Disability Students may also have a writing disability if they have difficulties with written expression. These students will have: Research has shown that the best ways to address challenges with written expression is to provide increased time for writing practice, sentence combining exercises, and strategy instruction. In one study in 2002, students made the most gains when instruction in essay skills was combined with spelling instruction. Self Regulated Strategy Development has also shown a lot of promise in the research as a way to develop strategies in students with LD and improve their writing skills. Reference: Fletcher, J.M., Lyon, G. R., Fuchs, L.S., & Barnes, M.A. (2007). Learning disabilities: From identification to intervention. New York, NY: The Guilford Press.

Mathematics Disability Inconsistencies in answers for mathematical operations (addition, subtraction, multiplication and division) – Ex. saying 5 + 4 = 20 Inability to remember formulas, rules, or concepts Difficulty with abstract concepts like time and direction Consistent errors when recalling numbers Difficulty remembering how to keep score in games May show deficits in working memory, visual-spatial skills, sequencing, and following procedures

Defining ADHD DSM-V is considered primary authority for diagnosis Two categories: 1) inattention 2) hyperactivity and impulsivity Symptoms must be present in multiple settings Children must have 6 symptoms for either/both group of criteria Adults (over age 17) must have 5 symptoms for either/both group of criteria Symptoms must be present before age 12 Typical behaviors: failure to pay attention to details, difficulty organizing tasks and activities, excessive talking, fidgeting, inability to remain seated in appropriate situations, difficulty sustaining attention on tasks that require effort. The DSM-V is the newest version of the DSM and was published in 2013. One significant change in the definition of ADHD is that age at which symptoms must be present (was 7, is now 12). While the DSM-V is viewed as the universal authority in the field regarding ADHD diagnosis, the DSM definition has been criticized because it relies on the medical model of disability. In an effort to have a child “fit” a diagnosis, other significant behaviors may be overlooked. This is important to consider given that some people with ADHD can thrive in many different environments outside of school. A study out of the University of Washington found that men with dopamine receptors in the brain linked to ADHD were more successful hunters and better nourished than those without this brain characteristic in a nomadic society. The reverse was true for settled societies. While part of defining ADHD as a disability requires that the condition cause difficulties with performance in “social, educational, or work settings”, the fact that success depends more on the setting than the person is telling (and suggestive of social model of disability). If we suspect ADHD, we will refer a family to a pediatrician. However, we should do this with caution given that ADHD-like symptoms can appear as a result of other issues or disorders. If symptoms are more likely the result of an emotional disorder, ADHD should not be considered a cause. In schools and under IDEA, ADHD is not a recognized disability category. However, because it is considered neurological, it is classified as an “other health impairment.” The OHI typically refers to medical conditions, which is another reason we encourage families to see a doctor, especially if they are interested in getting accommodations in the school. If you are interested in more details about identifying ADHD, take a look at the Manual posted on Blackboard from interventioncentral.org. Although this references the DSM-IV, many of the components are still relevant. References: http://www.dsm5.org/documents/adhd%20fact%20sheet.pdf; Wriight, J. (2002). ADHD: A school-based evaluation manual. Retrieved from: www.interventioncentral.org.

Executive Functioning Skills Response inhibition Time Management Working memory Goal-directed persistence (sticking with challenging tasks, such as problem- solving) Emotional control Sustained attention Flexibility (okay with changes in plans, tries multiple approaches to solve problems) Task initiation Planning/prioritization Metacognition (awareness of thinking, checks work, tries to solve problems) Organization Although having difficulties with executive function do NOT constitute a learning disability, executive functioning truly effects all aspects of learning in school. Executive Functioning Skills develop throughout childhood and into young adulthood, as the brain matures. Certain subtests in standardized assessments require various executive functioning skills. If interested, see book Executive Skills in Children and Adolescents: A Practical guide to Assessment and Intervention. Difficulties in any of the areas above can affect academic performance and progress at school. It is important to note that executive functioning deficits are not uncommon in children with learning disabilities and ADHD, but they can be taught with consistency over time!

Emotional Disorders Learning difficulties that can’t be explained by other factors Significant difficulty with relationships Inappropriate feelings or behavior under normal circumstances General pervasive mood of unhappiness or depression Physical symptoms or fears associated with personal or school problems This slide explains the IDEA criteria for emotional disturbance. This is something identified by a multidisciplinary team in a school. However, certain diagnosed conditions tend to be classified under this category. These include bipolar disorder, schizophrenia, anxiety disorders, severe depression, conduct disorder, and oppositional defiance disorder. Social maladjustment exclusion– technically excludes children from eligibility for special education, however, the term is ambiguous and there is currently no research base to reliably distinguish “socially maladjusted” children from those with emotional disturbances.

Emotional Disorders Defiant behavior linked to language/communication skills, literacy skills, and/or difficulties controlling impulses should be ruled out Emotional and behavioral challenges often co-occur with ADHD and Autism Spectrum Disorders Often display immaturity, acting like much younger children Behavior is inappropriate for developmental age Anxiety & Depression: Chronic, excessive fears, worries and/or uneasiness that impedes daily routines Difficulty concentrating, poor memory, inability to relax, trouble falling asleep Irritability, loss of interest in activities, loss of energy, change in appetite or weight Emotional disorders can be difficult to identify, given that learning difficulties and life stressors can cause anxiety, anger, and a range of emotions. Additionally, it is important to consider what is developmentally typical for a child. For example, preschoolers may experience separation anxiety from parents, elementary children have to navigate increasingly more complex social situations, and boys often have more difficulty with impulse control, organization, and sitting still than girls. Issues of bullying and struggles with learning can also lead to emotional instability, anxiety, and depression. Executive functioning skills are just beginning to develop in the middle school years and throughout high school, yet children have high demands on them to remember information and remain organized. Ninth grade is especially difficult due to biological changes, increasing demands at school, social complexities, development of identity, and a less developed prefrontal cortex (which is the area of the brain responsible for self-control, making decisions, and inhibiting responses)! It is therefore really important to differentiate between what is typical for an age and what is extreme behavior and emotional instability. Reference: Davis, M.R., Culotta, V.P., Levine, E.A., Rice, E.H. (2011). School success for kids with emotional and behavioral disorders. Waco, TX: Prufrock Press Inc.

Unique traits of Gifted Children Tend to have more fear, insomnia, and anxiety May have high levels of energy and intense focus Heightened sensitivities make it hard to “turn off” brain Tendency to ask deep questions; lack of answers may cause anxiety Creativity and imagination can lead to tendency to think about worse case scenarios, which can also lead to anxiety Tendency toward perfectionism and depression Uneven maturity and levels of development; cognitive maturity may be higher than emotional maturity Reference: Lamont, R.T. (2012). The fears and anxieties of gifted learners: Tips for parents and educators. Gifted Child Today, 35(4), 271-276.

Twice Exceptional Children ADHD High ability can mask ADHD May have difficulty making friends Character traits overlap Will need different accommodations than a typical child with ADHD Learning Disability (LD) LD can mask giftedness Giftedness can mask LD Easily frustrated by lack of understanding Uneven academic skills Over-sensitivity to criticism/blaming others Lack of organizational & study skills Given the unique traits of children with high cognitive/intellectual abilities, it can be difficult to determine whether characteristics are due to giftedness or a disorder. Traits of perfectionism, impatience, intensity, and curiosity are common in gifted children, but can be mislabeled as behaviors in ADHD. Students who are gifted and have ADHD often have trouble making friends with other gifted students, who may be impatient with the immaturity of the child with ADHD. It is important to note that typical accommodations, like shortening assignments, may not benefit a child who is gifted as easier work may make them bored, leading to other potential behavior issues. Learning disabilities in gifted students can present with many characteristics. Only a few broad characteristics are listed, but keep in mind we could add issues related to processing speed, memory, difficulty expressing ideas or getting to the point, difficulty following directions, distractibility, and difficulty controlling impulses. Children with LD may also have difficulty with social skills. References: “Consdierations: Twice Exceptional: Gifted Students with Learning Disabilities” (2014); Neihart, M. Gifted children with Attention Deficit Hyperactivity Disorder. Retreived from: ldonline.org.

Researching Disabilities

Resources to start your research http://ldaamerica.org

References Available on Blackboard: Christo, C., Davis, J.M., Brock, S.E. (2009). Identifying, assessing, and treating dyslexia at school. In Developmental Psychopathology at School. Lamont, R.T. (2012). The fears and anxieties of gifted learners: Tips for parents and educators. Gifted Child Today, 35(4), 271-276. Neihart, M. Gifted children with Attention Deficit Hyperactivity Disorder. Retreived from: ldonline.org. Wright, J. (2002). ADHD: A school-based evaluation manual. Retrieved from: www.interventioncentral.org. Resources from websites or books: http://www.dsm5.org/documents/adhd%20fact%20sheet.pdf http://www.dsm5.org/Documents/Specific%20Learning%20Disorder%20Fact%20Sheet.pdf “Considerations: Twice Exceptional: Gifted Students with Learning Disabilities” (2014). Retrieved from: http://education.wm.edu/centers/ttac/documents/packets/twiceexceptional.pdf. Davis, M.R., Culotta, V.P., Levine, E.A., Rice, E.H. (2011). School success for kids with emotional and behavioral disorders. Waco, TX: Prufrock Press Inc. Dawson, P. & Guare, R. (2010). Executive skills in children and adolescents: A practical guide to assessment and intervention. New York, NY: The Guilford Press. Fletcher, J.M., Lyon, G. R., Fuchs, L.S., & Barnes, M.A. (2007). Learning disabilities: From identification to intervention. New York, NY: The Guilford Press Hulme, C. & Snowling, M. J. (2009). Developmental disorders of language learning and cognition. West Sussex, United Kingdom: Wiley-Blackwell.