Intervention Plan - Research Paper Example

?Running Head: INTERVENTION PLAN- DYSLEXIA Intervention Plan- Dyslexia of the of the Intervention Plan- Dyslexia Introduction As reading teachers, we are rewarded as students become more confident with literacy. Unfortunately, each of us also has students who continue to struggle. John (pseudonym), a fourth grader, was one of those students. He has an average IQ and excellent listening comprehension, but automatic word recognition eluded him. These characteristics are indicators of dyslexia or a specific reading disability. (Robinson and Dally, 2008) For students like John, it is crucial that teachers understand dyslexia. This paper will provide a brief explanation of dyslexia and up to date brain-based research that supports explicit instructional suggestions in Intervention plan for John. What is Dyslexia? Dyslexia is an inborn disease that comes with sudden complexity in learning to interpret and pronounce words in relation to one's verbal aptitude, inspiration, and learning opportunities (Aylward et al., 2003). For John, the "unexpected difficulties" referred to his severe inability to decode unknown words, puzzling spelling errors, and slow reading rate. These were all apparent in the results from an informal reading and spelling inventory. These results indicated that he read at a first grade level. In contrast, he comprehended material read to him at a fifth grade level. This is common in students with dyslexia. They frequently are on grade-level in listening comprehension because grapho-phonological processing is not required. To explain this decoding weakness, researchers (Aaron, 2005; Shaywitz, 2003; Shaywitz & Shaywitz, 2005) have converged on the phonological model. More specifically, for students with dyslexia, recognising the phonemes in a spoken word, understanding the relationship phonemes have with letters, and blending (reading) or segmenting (spelling) them are unusually difficult processes. For example, as a beginning fourth grader John struggled to read and spell words such as shed (sep), stack (stuk), and slug (sog). Common Misconceptions The convergence on the phonological model contradicts several commonly held myths about dyslexia. For example, the most common misconception is that all students with dyslexia reverse letters. Dyslexia is not a visual disorder; in fact, students with dyslexia are often gifted in the area of visual arts (Davis & Braun, 2007). As young children begin to experiment with letters and sounds, many of them reverse letters. Therefore, letter reversal is not a reliable indicator. Another common misconception is that dyslexia is linked to low intelligence. A student must have an unexpected difficulty in learning to read and spell. If a student has a low IQ, the difficulty is expected. Students like John have verbal IQs within the normal range. Therefore, these students have the cognitive ability to read and spell on grade level. There are two other common misconceptions about dyslexia. One is that it is curable. Although there are effective instructional techniques and programmes that make the symptoms less severe (discussed later), dyslexia is not curable. Even as an adult John will struggle with fluent reading because of the extended time required for him to recognise unknown words. Spelling will also continue to be difficult. The other myth is that dyslexia affects males more often than females. As Shaywitz (2004) explains, this has more to do with the over-identification of males in all special education areas. In her studies, she found that the percentage of boys and girls with dyslexia is about even (Shaywitz, 2003). Reliable Indicators So, once a student enters school, what are reliable indicators? Dyslexia is developmental; therefore, the indicators change over time. Early on it is more difficult to recognise a student with dyslexia, but it becomes more obvious as they progress in school. Early On Even though it is important, prominent researchers (Muter, 2003; Shaywitz, 2003) agree that identifying children with dyslexia before third grade is difficult. There are several reasons, most notably: the books these students read contain repetitive words. Until late first grade, much of the reading students do is supported by memory and illustrations, not decoding. Therefore, students with dyslexia can be concealed by repetitive readings and predictable text. This concealment makes identification difficult, but not impossible. At the beginning stage, spelling is an excellent indicator. Not only must students decode, they must also segment the sounds of the words and generate specific letter representations. Because students begin "play" writing early in their literacy development, using spelling as an indicator is reliable (Shaywitz, 2003). A student that spells kite, KT, is demonstrating the ability to match spoken sound with letters. However, a student who spells mom, KT, has demonstrated a possible weakness in phonological ability. Fortunately, there are assessments available to help teachers pinpoint these early indicators. These assessments utilise students' ability to blend and segment phonemes as predictive instruments. Unusual difficulty in these tasks indicates that a student will have difficultly learning to read and spell (Felton, Wood, Brown, Campbell, & Harter, 2004). Any assessment similar to these should be used to identify students early so that intense intervention can be provided (Allington, 2000; Shaywitz, 2003). After Initial Reading Instruction By third grade, identification becomes easier. Early on students with dyslexia memorise parts of words or use visual cues (the golden arches for McDonalds) to read. However, once they advance in school there are too many unknown and low frequency words. They become frustrated as they realise visual cue memorisation is not enough. At this point, teachers will observe that a student's miscues have little relation to the correct word. When reading unknown words, students will begin to guess, usually based on the initial consonant. Additionally, students who have weak phonological skills overly rely on illustrations to compensate. Because intermediate books contain fewer illustrations, students like John are further frustrated. For instance, when John read a story about the circus he saw an illustration of a tent. The word tent never appeared in the text, but for each unknown word that began with a t, he read tent. As reading teachers, we must be aware of these tendencies because students with dyslexia can "hide" behind their ability to listen, comprehend, and respond orally in their regular classroom (Aaron, 2005; Davis & Braun, 2007). We need to teach students more effective methods. Fortunately, results from brain imaging research have pointed to effective methods. Identifying Word Recognition Regions in the Brain Based on contributions of neuro-imagery, there is evidence that certain intervention methods can evoke lasting positive change. Once brain-imaging technology allowed for precise pictures of brain activity, researchers were able to prove what Morgan predicted in 1896, that dyslexia is congenital. In the early 1980s, researchers made use of brain-images to show that students with dyslexia used different neural pathways while reading. More specifically, they were able to identify specific locations in the brain (left-posterior region) that were under-utilized. With additional technological advances, researchers were able to track brain activity in response to reading. When the brain is engaged, activity is reflected though variations in blood flow. That visible change allowed researchers to pinpoint the differences in neural patterns between students with reading disabilities and ordinary readers (Papanicolaou, Pugh, Simos, & Mencil, 2004). One of the contributions of neuro-imaging was identifying parts of the brain involved in reading. As more sophisticated methods were available, researchers began to compare images of students with and without severe reading disabilities. There is a difference in which regions of the brain are utilised. Some students utilise the region of the brain associated with word recognition (occipito-temporal region is circled). However, some students do not utilise that area. Instead, he or she compensates, by utilising the region associated with working memory and retrieval on the right front of the brain (Aylward et al., 2003; Shaywitz, 2003; Simos et al., 2002). This supports the belief that students with dyslexia rely on the retrieval of memorised words to the exclusion of other methods. Additionally, because this is a less efficient, more time-consuming neural pathway it explains why fluency is affected (Shaywitz & Shaywitz, 2005). These findings support what researchers surmised as the neural foundation of dyslexia. As exciting as these findings are for researchers, the findings that followed are even more exciting for teachers. Recently, converging evidence shows that intense phonological intervention can improve brain function during word recognition activities. Brain-Altering Interventions In the past six years, several different researchers have used neuroimaging methods in conjunction with intense instruction (one to two hours a day for several weeks) and concluded that instruction is capable of altering student brain functions. A student with dyslexia uses more of his or her right brain and less of the left. However, in three prominent intervention studies (Aylward et al., 2003; Richards et al., 2000; Simos et al., 2002) this pattern changed after intense phonics instruction. Even though interventions did not produce brain images matching those of ordinary readers, the images showed positive changes in that direction. With intervention, students' brains find more effective neural pathways leading to more fluent, automatic word recognition (Aylward, et al., 2003; Simos et al., 2002). The section that follows will identify and describe an intense phonics intervention used to help John. Intense Intervention for Students with Dyslexia After a year of working with John in a traditional small reading group, I realised he needed more. As others became more confident, he became more frustrated. John needed more than additional guided reading and whole word-word study. Because word recognition was his area of weakness, I administered the Wilson Assessment of Decoding and Encoding (WADE) (http://www.wilsonlanguage.com/index.htm) to determine his areas of strength and weakness. John was never formally diagnosed with dyslexia. The school system does not use the term, dyslexia. Instead, they use the term, specific-reading disability. Based on his WADE results, he had many of the characteristics described by Shaywitz (2003). As a fourth grade student, he had not mastered all of the consonants (q, x, v, y, z) or short vowel sounds (e, i, u). He also could not spell the words ship or bid. He needed intense phonological-based instruction beginning with a review of individual letter sounds. After researching several programmes and options, I chose an Orton-Gillingham-based programme because training was available through my school district. The instruction provided for John included all but one (early intervention) of the essentials of successful reading intervention (Shaywitz, 2003). John's instruction was intense (one-on-one format, four days a week), lasted over a significant period (one school year), and included research-supported instruction. Ideally, John would have been identified by the end of first grade, but I did not meet John until he entered third grade. Early identification might have saved John from four years of frustration. As shown in a study with over one thousand first grade students, Scanlon and Vellutino (2004) found when given one semester of intense intervention the population of students who were classified as disabled readers (below 15% on measures of basic word skills) dropped from 9% of the population to 1.5% of the population. Similarly, in a follow-up study (Vellutino, Scanlon, Small, & Fanuele, 2006), they found that when students were identified and received intense intervention in kindergarten, the number of students who needed additional intervention in first grade declined dramatically. Based on John's spelling samples in kindergarten, he might have been identified for this early intervention. At the end of that year, John's spelling was different from many other students. Unlike other students, most of John's spelling was still at the pre-alphabetic stage (Ehri & McCormick, 2004). John, the Multi-Syllabic Reader Several programmes, with various approaches, offer this type of intense instruction to help students like John. Shaywitz (2003) recommends some specific programmes in her book, Overcoming Dyslexia. Some of these include Alphabetic Phonics, Spell Read P.A.T., Orton-Gillingham, and Wilson Language. Her recommendations are evidence-based and are recommended by the prominent researchers in the field of dyslexia. Many of these are based on Sam Orton's seminal research. In these approaches, there is a structured system of sub-steps involving alphabetic principles, reading, spelling, and writing. Additionally, these employ a multi-sensory approach to instructing students. For example, John tapped his fingers to symbolise phonemes while reading and spelling, he manipulated letter tiles to spell words, and used visualisation and kinesthetic techniques to memorise the spelling of irregular words. During our first lesson in September, John studied short vowel words with three phonemes (mop, wish, and chop). John did not automatically read or spell these words during this lesson. Similar to the studies conducted by Aylwood et al. (2003), Simos et al. (2002), and Richards et al. (2000), John's lessons were systematic and included a synthetic phonics sequence (short vowel words with three phonemes, multisyllabic closed syllables, followed by open syllable words). We did not progress until he read the words automatically and could spell them correctly. As the months progressed, John became more confident. He began to understand the relationships between letters, sounds, and words and became cognizant of ways to break multi-syllabic words into syllables. Once John understood basic phonemic principles, his progress began to mirror other struggling readers. For the first time in five years of school, John felt confident with words. He was finally able to read and spell most one and two syllable words. In May our final word list included establish, reptile, combine, and compensate. John read these words accurately in isolation and in context. He also spelled similar words correctly. His final Informal Reading Inventory (IRI) results showed that his reading level increased from late first grade to third grade. Most importantly, half-way through the following year, his IRI results indicated his instructional reading level was fourth grade. Conclusion and Recommendations John had unanticipated problems in spelling and reading in relation to his verbal aptitude, enthusiasm, and academic opportunities (Aylward et al., 2003). Dyslexia and other severe reading disabilities are anticipated to affect 1.5-5% of the population (Aylward, et al., 2003; Vellutino et al., 2004). Similar to most disorders, there are varying degrees of severity. However, most students with a severe reading disability need intensive, systematic phonics instruction (Vellutino et al., 2004). John is just one example of how assessment-based instruction is effective. Hopefully, with continued support from trained reading teachers, students like John will continue to put forth the effort required of them. Brain-imaging technology proves that educators have the power to make positive, long-term change. If more teachers are aware of what dyslexia is (and is not), more students with dyslexia will realise it is more of a hurdle than a barrier. Additionally, teachers must make students aware of adults who overcame some of the difficulties associated with dyslexia (i.e. Albert Einstein, Patrick Dempsey, and Charles Schwab) and by doing so are successful in their chosen career. References Aaron, P. G. (2005). Dyslexia and hyperlexia: Diagnosis and management of developmental reading disabilities. Netherlands: AA Dordrecht. Allington, R. L. (2000). 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Overcoming dyslexia. New York: Knopf. Shaywitz, S. E., & Shaywitz B. A. (2005). Dyslexia (Specific reading disability). Biological Psychiatry, 57, 1301-1309. Simos, P. G., Fletcher, J. M., Bergman, E., Breier, J. I., Foorman, B. R., Castillo, E. M., etal. (2002). Dyslexia-specific brain activation profile becomes normal following successful remedial training. Neurology, 58(8), 1203-1213. Simos, P. G., Panagiotis, G., Fletcher, J. M., Foorman, B. R., Francis, D. J., Castillo, E. M., etal. (2002), Brain activation profiles during the early stages of reading acquisition. Journal of Child Neurology, 17(3), 159-163. Vellutino, F. R., Scanlon, D. M., Sipay, E. R., Small, S. G., Chen, R., Pratt, A., etal. (2004). Cognitive profiles of difficult-to-remediate and readily remediated poor readers: Early intervention as a vehicle for distinguishing between cognitive and experiential deficits as basic causes of specific reading disability. Journal of Educational Psychology, 88, 601-638. Vellutino, F. R., Scanlon, D. M., Small, S., & Fanuele, D. P. (2006). Response to intervention as a vehicle for distinguishing between children with and without reading disabilities: Evidence for the role of kindergarten and first-grade interventions. Journal of Learning Disabilities, 39, 157-169. Read More