1. A Cross-Battery Approach to Assessment of Psychological Processing Disorders
Milton J. Dehn, Ed.D Winter 2011
Schoolhouse Educational Services

2. Copyright Notice; Copyright, 2010
The content of this PowerPoint presentation and accompanying handouts is copyrighted by Schoolhouse Educational Services, LLC and Milton J. Dehn. It is not to be reprinted, copied, or electronically disseminated without permission. To obtain permission, contact Milton J. Dehn at

3. Workshop Topics Processing overview and MN’s criteria
Processing and learning
Organizing a processing assessment
Cross-battery testing and analysis
Interpreting results
Determining eligibility
Evidence-based interventions overview

4. What is psychological processing?
Brain’s 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
Can’t learn and perform without processing
Doesn’t include knowledge base, skills, or what is stored in long-term memory
Topic limited academic learning processes

5. Problems with Past Processing Assessment
Not enough known about processing
Not sure how to test processing
Assessment too informal (grad. example)
Over emphasis on low level processes
Memory seldom assessed
Some ineffective interventions

6. Now Is the Time
Better understanding of psych processes and their relations with specific academics
Neuroscience and neuropsychological evidence on brain and learning
Neuropsychological influence on assessment
Research on processing, memory, academics
More assessment of memory
New research on interventions
Better assessment options

7. Why Processing Assessment is a Good Idea
Process. deficits underlie (“cause”) SLD
Identifying a processing deficit differentiates SLD & slow learning
Understanding of the learner
Interventions for the processing deficits
Identifying processing deficits provides direction for academic interventions
Assessment benefits the learner

8. Processing and RTI Compatibility
RTI purists are not current; too behavioral
Processing model consistent with problem-solving and early intervention
Evidence-based processing interventions
Why do “blind” general academic interventions
Different causes of disabilities
Processing and academics are compatible
Which academic interventions succeed?
Those that address processing problems

9. “Resistance” to Intervention
Successful achievement depends on adequate psychological processes
Process deficits impede learning
A processing deficit can cause an academic intervention to fail---example
When severe; When not addressed
When intervention options limited
Processing testing can determine whether failure to respond to RTI is due to a processing deficit, adding more support for LD placement

10. Processes and IQ Processes underlie intelligence
Processing versus content (e.g. verbal)
Global IQ versus specific processes
Processing problems can pull down IQ

11. IQ-Achievement Discrepancy Model and Processing
Discrepancy model misses some SLD
Deficient processing “pulls down” IQ
Poor achievement “pulls down” IQ
With processing, use a consistency approach, not a discrepancy approach
Low process + low academic skill = SLD
NOT high process + low academic skill

12. Psychological Processing Model
Cognitive psychology theory of learning
Input – output memory model of processing Link
More parallel, complex, and integrated than can be represented
Neuroscience supports model: these are brain-based processes
Memory functioning is the core

13. Psychological Processing, General Characteristics
There’s a flow of information
Mostly automated
Parallel, complex, and integrated
Executive functions exert control; affected by effortful, conscious control
Some input is internal from memory
Neuroscience supports cognitive model
Link

14. What the Brain Needs for Learning
Attention
Organized information to input
Both visual and auditory
Metacognition and strategies
Repetition
Sleep, glucose, oxygen

15. Brain Lobes and Processes
Frontal Lobes: Attention, Exec. Functions, Fluid Reasoning, Working Memory
Temporal Lobes: Long-Term Memory, Auditory, Short-Term Memory
Parietal Lobes: Fine motor, Working Memory, Auditory, Phonological,
Occipital Lobes: Visual
The Hippocampus, absolutely essential for learning

16. MN SLD Definition
“Specific learning disability means 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 the imperfect ability to listen, speak, read, write, spell, or do mathematical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia”

17. MN Processing Criteria
“The child has a disorder in one or more of the basic psychological processes which includes an information processing condition that is manifested in a variety of settings by behaviors such as inadequate …. (next slide)

18. MN Processing Criteria
….acquisition of information; organization; planning and sequencing; working memory, including verbal, visual, or spatial; visual and auditory processing; speed of processing; verbal and nonverbal expression; transfer of information; and motor control for written tasks.”
(list is not exhaustive; essentially covers all major aspects of information processing) See Handout

19. Minnesota SLD Criteria
A basic psychological processing deficit must be documented across multiple settings using a variety of sources under the IQ severe discrepancy option or the inadequate rate of progress (RTI) option
Two prior interventions required
Observation required

20. Dehn’s Recommended Processes for SLD Assessment
Attention
Auditory Processing
Executive Functions
Fine motor Control
Fluid Reasoning
Language Processes
Long-Term Memory Recall
Phonological Processing
Processing Speed
Visual-Spatial Processing
Working Memory (See Handout)

21. Attention Frontal lobes Cognitive levels of attention; not arousal
Types: Selective, focused, divided, sustained
Necessary for acquisition
The problem is attentional control
Lack of inhibition
Under executive control
Interest of material is a factor
Attention weakness often part of SLD
Learning: A necessary prerequisite for all learning and memory

22. Auditory Processing
Ability to perceive, analyze, synthesize, and discriminate auditory stimuli, e.g. speech
Phonological processing may be a subtype
Learning: Perceiving and comprehending instruction; being able to understand words with background noise

23. Executive Functions More to do with performance than skills
Involves management of cognitive functions and psychological processes and also skills
Complex; difficult to assess as a whole
Includes planning (easiest to assess)
Organization depends on executive functions
Effectiveness depends on self-monitoring, self-regulation, and metacognition
Related to use of learning strategies
Learning: Knowing how much you need to study material

24. Executive Control Processes
Self awareness (metacognition)
Awareness of strengths and weaknesses
Awareness of the task requirements
Awareness of which strategies work
Self regulation (metacognition)
Monitoring; evaluating; planning
Detecting errors, problems
Deciding which strategy to use
Fixing the problem

25. Fine Motor Control Is it perceptual or motor?
Seems related to attention
Does it interfere with learning or just written performance?
Interventions for it do not improve learning but may improve performance
Learning: Be able to copy letters accurately

26. Fluid Reasoning A higher level process (close to IQ)
Inductive and deductive reasoning
Learning: problem-solving, math reasoning, comprehension

27. Language Processes
Not the content (vocabulary) or the written output but the oral processes
May acquire knowledge but have difficulty expressing it
Retrieval may be part of the problem
Learning: Oral expression of thoughts, ideas

28. Long-Term Memory
Not specifically part of MN criteria but important part of info. processing & learning
Some students learn well initially but can’t retain; others learn poorly but retain well
Difficult to measure
Not known what has been learned
Intervals in tests not long enough
Deficits due to hippocampal damage

29. Rapid Automatic Naming (RAN)
Naming facility for commonly known objects
Highly predictive of early reading achievement
May be associated with slow long-term retrieval speed or slow processing speed

30. Phonological Processing
Processing of phonemes, e.g. blending
Phonemic awareness is part of
Related to language and literacy development
Related to phonological short-term memory
Learning: Recognizing rhyming words, segmenting words into phonemes

31. Processing Speed
How quickly information flows through the processing system; a matter of efficiency
Too slow: info. lost, process not completed
Speed increases significantly until adolescence
Adolescents 2x faster than 8 year olds, 3x than 4 years
Related to retrieval speed, RAN
Learning: Rapidly computing and retrieving the answer to simple math calculation, reading fluency
Case example

32. Visual-Spatial Processing
Ability to perceive, analyze, synthesize, manipulate & think with visual patterns
A strength in most LD cases
Visual and spatial can be differentiated
Not that correlated with academic learning in general
Orthographic is stronger
Learning: Distinguishing between shapes

33. Orthographic Processing
A subtype of visual processing
Has to do with processing of letters, symbols, and words
Should be assessed
For example, PALS

34. Working Memory Includes short-term memory
Processing while retaining information
Four units of information at a time
Very important for learning & performance
About half of LD students have a deficit
Involves executive functions
Needed for language development (ESL?)
See monkey video

35. Working Memory Includes auditory and visual processing
Includes sequencing
Related with processing speed
Is the interface between input and storage
Some information in working memory is retrieved from long term memory
The most common processing weakness
Automaticity increases capacity

36. Types of Working Memory
Verbal Link
Visuospatial
Executive
Episodic
Activated long-term memory items
Learning: Being able to take notes while listening

37. Long-Term Memory Systems
Episodic: memory for events, Link autobiographical, context, details
Learning is initially episodic, then semantic
Semantic: facts, knowledge, vocabulary
Abstracted from episodes
When tested, divided into visual and verbal (both episodic during standardized memory testing)
Implicit: unconscious, includes procedural

38. Long-Term Memory Processes
Encoding
Consolidation
Storage
Retrieval---most directly measureable
Learning: Knows a fact but can’t recall when needed without prompting

39. Forgetting Fast at first, then slows down
50% forgotten within 24 hours
Some retain well within 30 minutes or 1st day but then have very poor retention afterwards
Is it lost, or not retrievable at moment?
Interference: proactive and retroactive
Recognition versus free recall

40. Consolidation Often ignored Evidence from TBI and amnesia Takes time
Unconscious mostly
Movement from medial temporal lobe/hippocampus to cortical areas
Episodic to semantic
Much of it occurs during sleep

41. Strategy or Processing Deficit
Effective strategies enhance processing
LD students are deficient in use of strategies
Difficult to assess and differentiate
Learning and using strategies requires more processing until they become automated (WM Catch 22)
LD due more to processing deficits than lack of strategies

42. Development of Processes
Early gradual development followed by long-term plateau: auditory processing, visual processing, long-term memory
Rapid early development followed by gradual decline after age 25: processing speed, short-term memory
Basic functions develop earlier; higher level, such as executive (frontal lobes), later

43. Processing the Workshop Info.
Explain to a parent what psychological processing is, in general
Then explain one of the 10 processes to a parent

44. Processes and Academic Learning
See Chart
Relationships established through research
During assessment look at processes related to area of academic concern
Discuss these evidence-based links in your reports to justify placement

45. Highest Influence of Processes on Academics by Grade
Early elementary: Phonological, visual, auditory, rapid automatic naming, STM, sequencing, fine motor control
Late elementary and beyond: Executive, working memory, long-term memory, planning
All grades: Processing speed, attention, verbal expression

46. 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

47. WISC-IV Profile for Reading Disabled Sample
Perceptual Reasoning 94.4
Processing Speed
Verbal Comprehension 91.9
Working Memory

48. WISC-IV Profile for Math Disabled Sample
Verbal Comprehension 93.2
Working Memory
Processing Speed
Perceptual Reasoning 87.7

49. What is a Processing Disorder?
Disorder---a group of symptoms involving abnormal behaviors or a disruption in physiological functioning
Not many official processing disorders
E.g. CAPD, aphasia, amnesia, dyspraxia
A disorder involves deficits
Deficit---a lack or shortage of something
Weakness---lacking normal ability

50. Evidence of a Processing Deficit
It’s not specific to one environment
Both an intra-individual weakness and a normative weakness (deficit per Dehn)
A normative weakness is a score below 90
Intra-individual: score is 12 or more points lower than IQ or mean of assessed processes
A low score in a process is not necessarily a deficit indicative of LD, unless it’s also an intra-individual weakness
E.g., very low IQ have inherent processing problems

51. Deficits Indicate Disabilities
Deficits (double weakness) are rare
They have an underlying neurological basis
They impair learning
Students with below average IQ are less likely to have
Deficits more predictive of need for LD than an ipsative weakness alone.
Below average processing (normative weakness) is still a processing weakness that impacts learning and benefits from intervention

52. When Does a Processing Deficit Support an SLD Diagnosis?
When it’s a double weakness deficit
When the process is one that is related to the academic skill deficiency
When a process is significantly higher than related academics, it’s not SLD but some other cause of poor skills (example)
When both the academic skill and process are similarly low (consistency approach)

53. Consistency Approach
With processing, use a consistency approach, not a discrepancy approach
Low process + low academic skill = SLD
NOT high process + low academic skill

54. Normative Weaknesses Only
Normative weaknesses that are not also ipsative deficits may still be indicative of processing deficits that are impeding academic learning and causing a learning disability, as long as there is a pattern of strengths and weaknesses
Normative weaknesses that are not ipsative weaknesses should targeted for intervention

55. Discussion: Processing the Workshop Information
How would you explain to a parent what psychological processes have to do with learning
For example, what is working memory and why is it important for learning
Pick 2 or 3 processes that you consider the most important for academic learning, in general, and explain why

56. Processing Assessment Challenges
Connecting to academic concerns
Interrelated processes
Informal methods lack validity
Not found in one convenient battery
Doing it efficiently
Having enough expertise
Connecting with interventions

57. Records Review Any medical or health conditions Developmental delays
Look for indications of same behaviors that could be observed
Difficulty memorizing arithmetic facts could be a working memory deficit
Difficulty blending could be phonological proc.
Low fluency could be processing speed problem

58. Interviews From middle school up, do interviews
E.g., “Do you often forget what was just said?”
Teachers: Ask about observable behaviors, then ask their hypothess
With parents, use home environment examples
“Does your child have difficulty rhyming?”
See examples

59. Observations
Some processes more observable than others, e.g. memory is more observable
There’s no one-to-one correspondence between a behavior and a process
Each behavior depends on multiple processes; try to narrow it down
E.g., poor organization could be due several
(organization is not a specific brain process)
See examples

60. Observations of Working Memory
Abandonment of activity
Reserved in group activities
Short attention spans
Poor monitoring of work quality
Loses place in complicated tasks
Examples of evidence-based behaviors associated with WM deficiencies Link
See also LTM observations

61. Observations During Testing
Corroborates scores
Examples:
Speed
Retrieval
Needing directions repeated
Attention
Fine motor

62. Cross-Battery Method Administer specific subtests/factors only
Mix tests/batteries to cover all the processes (at least those of concern)
Limit to 2 or 3 batteries
Should be normed about the same time
Avoid redundancies
Ideally, 2 subtests per process
Analyze results together by computing a cross-battery mean

63. Cross-Battery Criticisms
Only some subtests are administered
Tests may have been normed at different times
Different subtests with same names measure different tasks & vice versa
There are no norms for the cross-battery mean
It relies mainly on subtest analysis

64. Dehn’s Approach to Cross Battery versus Flanagan’s
Not limited to CHC factors
CHC factors are too broad; some processes need to be differentiated, e.g., phonological from auditory and visuospatial short-term memory from visuospatial
Not Quantitative reasoning, and crystallized
Analyze scores at the factor (two-subtest) level whenever possible
Use a hand computation analysis sheet
A more neuropsychological approach

65. Hypothesis Testing Approach
Collect preliminary data
Records review, observation, interview
Identify referral concerns
Generate processing hypotheses (suspected processing problems)
Select batteries/tests/subtests
Cover all hypotheses
Avoid redundancies

66. Selective Testing Not necessary to administer entire battery
Focus most on hypothesized deficits
Know the factors/subtests that measure processes
Apply a cross-battery approach
See selective testing table for cog. & ach.

67. Completing the Processing Assessment Planner
Enter academic learning referral concerns
Look at Table 1: Processes and learning
Enter hypothesized, suspected processes
Select assessment method
Look at selective testing tables
Select battery
Select specific subtest or factor
Planner

68. Case Study: Hannah Concerns:
Struggles in math, reading comprehension, and written expression
Does poorly on classroom exams
Difficulty learning new concepts
Background: adopted; slow speech dev.; retained in K; learning problems since K
Strengths: Oral expression, vocabulary
Completed Planner Example

69. Cross-Battery Analysis of Scores
See Processing Analysis Worksheet
Get factor scores from test manual when possible
Exclude non-processing factors and subtests
Compute clinical factor scores by averaging
First convert scaled scores to 100/15 metric
Compute processing mean or use IQ
Calculate difference scores
Determine weaknesses and deficits
Do pairwise comparisons

70. Examples of Logical Processing Pairs
Visual vs auditory
STM vs LTR
Phonological vs STM
Attention vs Executive
Auditory vs verbal expression
Verbal expression vs fine motor control
WM vs STM
WM vs LTR

71. Case Study Hannah’s Results
Full Scale IQ = 89
Basic Reading Skills = 95
Reading Comprehension = 81
Mathematics Reasoning = 82

72. Case Study: Hannah (finish example)
Identify normative weaknesses/strengths
Identify ipsative weaknesses/strengths
Identify deficits and assets
Which processing hypotheses are supported and which are not?
Look back at planning sheet

73. Case Study: Hannah Use Hannah’s data What are her processing deficits?
Do they link with her learning and achievement problems?
Does her processing profile explain her academic learning problems?
Does she qualify for the processing component of LD?
Does she qualify for LD overall?

74. Assessing Processing with Wechslers
Processes assessed by Wechslers
Processing speed
Visual processing---compute clinical factor
Working memory (not WPPSI-III)
Need to supplement with other scales
Processing interpretation will be based on processing factors only; exclude Verbal Comprehension Index

75. Wechsler GAI Score General Ability Index
A traditional measure of IQ based on 6 core subtests
Recommended for IQ-Ach discrepancy when processing speed or working memory are pulling down FSIQ
However, do not use for determining processing strengths and weaknesses

76. WISC-IV Integrated 16 additional process subtests
Requires regular WISC-IV administration
Based on Kaplan neuropsych approach
To parse out the cognitive processes that underlie subtest performance
Select subtests based on hypotheses
Emphasizes subtest and intrasubtest interpretation

77. WISC-IV Integrated Best for in-depth working memory testing
Processes measured by process subtests:
Visual processing
Planning/executive processing
Long-term retrieval
Short-term memory (registration)
Working memory (manipulation)
Visual
Auditory

78. WISC-IV Integrated Interpretation
Compute clinical factor scores
Short-Term Memory
Visual Short-Term Memory
Auditory Short-Term Memory
Working Memory
Visual Working Memory
Auditory Working Memory Link
Use processing analysis worksheet

79. WJ III Cog. Ideal: measures several processes Link
Works well as CB supplement to other tests
Has at least 2 subtests for most processes
Processing analysis worksheet needed less
Co-normed with WJ III achievement

80. WJ III COG Interpretation Options
Use Compuscore Intra-Cog. Discrepancy
Use 1 SD as ipsative significance indicator
Use Predicted Achievement/Achievement Discrepancy
Predicted achievement is based on the processes that are most related to the skill
The process scores are weighted
Look for consistency or even lower achievement
Use processing analysis worksheet if other tests
Omit Comprehension-Knowledge

81. Assessing Memory Should be a priority with LD referrals
Intellectual/cognitive scales not enough
Many different types of long-term memory
Semantic is primary for academic learning

82. WRAML-2 Authors: Adams and Sheslow Published by Wide Range, 2003
Ages 5-90
Has a new Working Memory Composite
In 1990, WRAML was 1st well normed test battery for memory assessment in children
Normed on sample of 1200
Assess memory subcomponents

83. WRAML-2 Composites General Memory Verbal Memory Visual Memory
Attention/Concentration
Working Memory
Verbal Recognition
Visual Recognition
General Recognition

84. NEPSY-II Neuropsychological test (SPs with training) 2007, Pearson
Authors: Korkman, Kirk, and Kemp
Ages 3-16:11
34 subtests across 6 domains
Based on Lurian tradition of looking for subcomponents that may underlie impairment of system

85. NEPSY-II Processes in 6 Domains
Attention and executive functioning
Language
Memory and learning
Sensorimotor
Social perception
Visuospatial processing

86. Testing Processes with Achievement Tests
WJ III Achievement
KTEA-II
WIAT-III
Link

87. The BRIEF Behavior Rating Inventory of Executive Function
Parent, Teacher, and Student Forms
Ages 5-18; 86 items
Normed in the state of Maryland only
Has a global executive composite score
Two Indexes: Behavioral Regulation and Metacognition

88. The Brief’s Scales Inhibit Shift Emotional Control Initiate
Working Memory (weak scale)
Plan/Organize
Organization of Materials
Monitor

89. Children’s Psychological Processes Scale (Dehn)
Available fall of 2011
Scaled score for each of the 11 processes discussed today
Teacher rating scale, about 130 items
Entirely online, except manual
Will provide documentation of patterns of strengths and weaknesses
More MN subjects needed

90. Other Tests
Includes rating scales, self-report scales, specialized process tests, etc.
Learning Efficiency Tests (LET-II): Memory
See List

91. General Interpretative Guidelines for Processing Assessment
A deviation from a reference point IQ
Cross-Battery mean
Related pairing (not best evidence of deficit)
Normative versus ipsative
With both, impairments more likely
Qualitative information
Corroborating information

92. Interpretative Guidelines
Go beyond test labels; reclassify
Consider disability profiles
Link to achievement deficit
Consider influence of related processes
Consider strategy deficiencies
Okay to focus on subtests/subprocesses
Consider interventions
Consider other causes

93. The Influence of Other Factors on Process Test Performance
Poor processing performance maybe due to lack of strategy development
May be due to lack of exposure and opportunities, e.g. phonemic awareness lower in lower SES
Temporary medical conditions, e.g. concussion
Brain process may be deteriorating

94. Report Writing Recommendations
Do not report on a test-by-test basis; rather process by process
Integrate data from other sources
Explain how the processing results were analyzed, including processing mean
Distinguish between normative and ipsative weaknesses
Define each process See Example

95. Case Study: “Jacob” Age 13; 7th grade
Foster care; special ed placement
3 months premature; failure to thrive
Early elementary IQ of 70; recent IQ of 95
ADHD diagnosis; poor organization
Social skills problems
Difficulty completing homework
Moderately high test anxiety

96. Case Study Continued Likes to read
Struggles with Math and Written Lang.
Reading Composite – 106
Math Composite – 88
Wr. Lang. Composite – 73
Oral Lang Composite - 87
List your processing hypotheses to account for low achievement and background factors

97. Case Study Continued Finish Jacob’s Proc. Analysis Worksheet
What are his processing deficits?
What are his processing strengths?
Do his processing deficits link to his low achievement areas?
Does his processing profile explain his learning difficulties?
Does he qualify for SLD in processing?
What else should be tested?

98. Determining Psych. Processing Deficits for MN’s SLD Criteria
Use Jacob’s data
See MN worksheet; go through steps
What are his processing deficits?
Do they link with his learning and achievement problems?
Complete other steps.

99. Case Study Continued
Discuss how you will explain to Jacob’s parents and teachers how his processing deficits are impacting his academic learning
What strengths does Jacob have that might be utilized during interventions?
Which processing areas are most in need of intervention?

100. Conclusions About Processing Assessment
It can be done well but there are challenges
Professional judgment is necessary
Selective, cross-battery testing necessary
Test the processes associated with the academic deficiency
Use the consistency approach
Explain the link

101. Interventions Should be brain-based; change the brain
Strengthen weakness when possible
Teach strategies
Some are content specific
Some are similar to study skills
Metacognitive aspect is important
Can be part of effective instru

102. Group Discussion Which assessment procedures do you plan to use?
What recommendations do you plan to take back to your district for processing assessment?
How do you view the processing assessment-intervention link?