How to Identify Reading Difficulties

Week 2 of the Supporting Children with Difficulties in Reading and Writing.

Definition and Causes

• Dyslexia is a neurologically-based condition, which is often hereditary. It results in problems with reading, writing and spelling. Also usually associated with difficulties in concentration, short term memory and organisation.

• Dyslexia is NOT caused by poor schooling or home background or by poor motivation for learning. It does not clinically manifest with poor sight, hearing or muscle control - although it may occur with these conditions.

• Matthew effect - if child struggles to decode they will read less texts over time, exposed to less new vocabulary and so results in lower vocabulary level compared to peers later on.

• Why do children have these problems? 

• Decoding struggles - these children tend to struggle with phonological processing. Problem with manipulating sounds in words.Dyslexia usually associated with visual problems and there are often these as well but primarily it is a phonological issue. Harder to automatically link sounds and letters.Also might be a separate matter with speed of processing which can exacerbate the phonological issues.

• Strong genetics component to dyslexia caused by mulitple genes. Continuum of effect.

•  Early intervention critically important. Children who are late talkers often go on to have reading difficulties.

Identification - Pre-Primary

• Dyslexia exists from birth.
• Risk factors for dyslexia (not to be considered in isolation - combination of risk factors and consistency over time) before the child learns to read: 
        
1. Dyslexia in the family. Did parents, grandparents have difficulties reading and writing?
2. Ambidextrous, difficulty establishing manual preference.
3.  Persistent confusion between left and right.
4. Inability to appreciate rhymes in nursery rhymes and songs.
5. Difficulty following a rhythm and reproducing it.
6. Difficulty learning songs or poems by rote.
7. Difficulty naming familiar objects - finds it hard to access the name of something even if it is known.
8. Difficulty in following a sequence of instructions.. They have a difficulty with short term memory.
9. Difficulty in saying words - will confuse sound order. 
10. Difficulty with organisation and frequent loss of personal items.
11. Difficulty with time and space eg before/after, tomorrow/yesterday. 

Identification - Primary

• Things to look for (persistent over time):
        
1. Auditory confusion between similar phonemes eg buh/puh/duh.
2. Visual confusion between graphemes that are similar eg p/q, n/u, f/t.
3. Inversion between letter and syllables.
4. Addition of letters, syllables or affixes.
5. Omissions of elements of words.
6. Substitution of words, guessing words.
7. Contraction or de-contraction. Misusing word boundaries.
• Other behaviours:
        
1. Lose the thread of what they are reading. Re-read the line two times without being aware they are doing it.
2. Read/write a text in present tense instead of the past or future.
3. Very inconsistent autography - same word spelled in several different ways in same piece of writing.
4. Ignoring punctuation, no intonation.
5. Writing is very slow.
6. Fatigue. First long OK, end of product mistakes

Informal Assessment

• Combination of several symptoms, frequency despite your correction ad persistence over time.
• Examine phonological awareness in child. Difficulty in manipulating sounds of language.
• Complexity differs - syllables are easier than onset rimes which are easier than phonemes.
• Important to pronounce pure sounds eg t not "tuh"
• Eight tasks:
        
1. Generation - get child to generate words containg the same ending, final syllable or rime as a target word.
2. Detection - give three words to child and find odd one out. Child has to retain words in memory and give answer.
3. Blending - syllable give me the whole word "te-le-vi-sion"; onset rime - what do you get when you join up "tr and ap; phoneme - c a n a l
4. Segmentation - Give child word and divide into syllables, onset rime and phonemes.
5. Deletion - syllable eg say word cabin, now say it again without "ca", phoneme - meat say it again without m.
6. Substitution - track - what would happen to it if I replaced tr with cr.
7. Phoneme Fusion - first phoneme of two words eg big apple = ba
8. Inversion - eg invert two first consonants in a word and say the word. Very complex!!
• Irregular words - said, yacht, knight etc. You can't use phoneme code you need to know these words. Have to use direct access path. Typical mistakes are regulatisation.
• Pseudo words - invented words. Can only be read by phonological decoding route.
• If they can read pseudo words better than irregular words then you know that phonological decoding is working quite well. Direct access route not so good. Errors include lexicalisation - eg labbit - rabbit (overuse of direct access path); addition/omission/ inversion.
• IF they are reading irregular words well and pseudo words poorly then you know direct access route is working well but phonological decoding route is not.
• Text comprehension - find suitable text. Evaluate comprehension. Assess child' background knowledge of the topic of the text:
        
1. What do you know about the subject?
2. What do you think the text is going to be about?
• Gives you an idea of their knowledge before they read.
• Present the text. They read text aloud. Have two copies of text so you can record errors and if possible, record them. 
• Assess their comprehension. Either recall task - get child to tell what the text was about eg describe it to someone who hasn't read the story (look for sequence, central idea, details, basic structure, precise, omissions). Explicit and implicit questions about the text.
• Assess strategy used for completing information. Present text again to child and ask questions that were not correctly answered and analyse the strategy they use to find the answer in the text.
• Analyse mistakes in reading. Positive errors - omissions, insertions, changes in sequence, inattention to punctuation, repetition of part of a word, self correction where meaning is not changed. Negative errors - omissions, insertions, changes in sequence, inattention to punctuation, repetition of part of a word, refusal to read a word where the meaning is altered.
• Using the results - stimulate positive strategies eg link more to prior knowledge, pay more attention to punctuation, improve decoding strategies, encourage self correction. Guide child away from strategies that are being over used eg relying on context to guess a word.
• Assessing sequencing abilities - dyslexics find thing like alphabet, months of year, multiplcation tables etc hard. Design a test - name months of the year. for older children - what letter comes before "p"?
• Rapid automatised naming - name as quickly as possible and without mistakes. Dyslexics are much slower at this. Uses pictures - don't put learner in a situation where they "fail".
• Auditory short term memory - digit span test. Keep increasing until the child makes two mistakes in a row. Then you stop. Do the test again and ask child to repeat in reverse order. In primary school, digit span forward is usually 4-5, backward 2-3. Dyslexic usually much lower.
• Visual short term memory - copying test. Copy text as quickly as possible (eg in 2 minutes). Stress mean dyslexic learners will make mistakes.
• Finding shapes - bell test. How many do they find? What strategy do they use? Dyslexic usually more erratic.
• Sequence comparison - series of letters - are they the same? 

What Can you Do with Test Results?

• If child has difficulty in phonemic awareness and difficulty with pseudo words - design a programe to enhance phonemic awareness and improving the phonological route.
• Child has greater difficulty reading irregular words and much better short term memory for visual rather than auditory materials. Teach irregular words with flashcards.