Episode Transcript
[00:00:01] Speaker A: Hi, I'm Maggie.
[00:00:01] Speaker B: And I'm Nicole. Welcome to the DAC Dyslexia and Coffee Podcast. We're so happy you could join us. We're both moms and dyslexia interventionists who want to talk about our students and children. What dyslexia is, how it affects our kids, strategies to help and topics related to other learning disabilities will also be covered in this podcast. Parents are not alone, and we want to give a voice to the concerns and struggles we are all having. This is a safe place to learn more about how to help our children grow and succeed in school, in the world. Grab a cup of coffee and enjoy the conversation.
[00:00:35] Speaker A: Hi, everybody. We're gonna start with the concept of the week, which is the way we like to start all of our episodes. The concept of the week this week is standardized assessment. Okay, so a standardized assessment. This is a question we get asked pretty often. What does that mean? It means that the tests that are considered standardized are administered under pretty uniform conditions with the same questions and the same scoring methods. So it allows for consistent and comparable results across individuals or groups. So these are put out by publishers. They have been very careful. A lot of them are very scripted. You must say this, you must say it this way. If you're going to get feedback, there is a specific phrase that must be used to do that. These kinds of assessments are used typically for diagnostic purposes and to identify learning gaps.
[00:01:48] Speaker B: So welcome to episode 32. So we thought we would talk about how we test for dyslexia.
[00:01:55] Speaker A: Yeah. So not all dyslexia assessments are created equal, but we are going to walk you through how we here at the Dyslexia Achievement center test for dyslexia. And also for those of you who are, you know, outside of our geographical area, this is going to be a worthwhile conversation for you too, because we're going to talk about what really should be included in an assessment for dyslexia. So we are going to talk about actually what we do here, but what you should be looking for if you're seeking an assessment outside of southeastern Wisconsin, where Nicole and I are based.
[00:02:40] Speaker B: Yes.
So for the Dyslexia Achievement center, we use both formal standardized and informal assessments to get a good background and be able to compare all the data.
[00:02:57] Speaker A: Yeah, and just kind of a point of clarification, when we say informal assessments, all that really means is that they're not necessarily standardized or what we call norm referenced. It doesn't mean that they're just purely subjective. Sometimes that is a point of Confusion. I do get asked that from parents often. Well, what do you mean by informal measure? Usually these are still a published product, but it might be something like we're looking for benchmarks, for example, something like Alphabet order or alphabetic principle. We're going to use a formal, an informal measure and we're going to talk about qualitative data. Like this is how automatic they were. But we're not comparing that back to their same age peers. That's what makes it informal.
[00:03:57] Speaker B: Correct.
So some background information that we gather, we do have a red flag sheet. It's on our website. Anybody can download it.
And we always want to see kind of the history of the student. It goes from preschool all the way up to adult. So kind of the red flags that we look for to see. And if you have more than three on that sheet, you should be talking to somebody about what's going on.
We also do a family history. Obviously we've talked in other episodes about how dyslexia is hereditary, which means it comes through family members.
So that's very important to know. Or if there's any other learning disabilities in the family.
We ask about school history.
What type of interventions have they had? Have they had any interventions? Have they ever been behind, even in early preschool and just kind of looking at, you know, not really grades, but how their overall functional academics have been.
[00:05:12] Speaker A: Performance been tracked over time.
[00:05:14] Speaker B: Correct.
We look at medical history because dyslexia is a medical diagnosis.
And so that's also something important to know. And if there's any other medical diagnosis that might impact reading, any reading intervention history.
And also if there's any other diagnoses, like if there's a history of epilepsy or something in the student, then we need to know that because that can impact learning.
[00:05:44] Speaker A: Also, you know, chronic ear infections is something we specifically ask on that medical history because it does have a correlation with dyslexia.
[00:05:58] Speaker B: They don't know why yet, but it's out there.
[00:06:01] Speaker A: Yeah. I mean, we do know that it has a lot to do with like the phonological awareness.
[00:06:06] Speaker B: Right.
[00:06:07] Speaker A: Being impacted. If someone has a, has chronic ear infections, especially as a young child, that can really affect that developmental window of time when our brain is sorting those speech sounds and matching them to actually like the motor component of making those speech vowels. So chronic ear infections can interrupt that because if your ears are always full of fluid, you're not hearing clearly. And it's not necessarily a hearing problem, it's that you're being blocked.
[00:06:40] Speaker B: Exactly.
We also look at the Family history of dyslexia or reading difficulties. There's a lot of probably adults and older adults that never were tested, but maybe like great aunt so and so was never able to read. And that's good to know because that could be dyslexia.
[00:07:02] Speaker A: Yes.
[00:07:04] Speaker B: We ask about teacher and parent concerns, what they're seeing, observations in the classroom and at home based on reading, writing and math.
And then we actually asked our students how they feel about reading and if anything is difficult and why.
[00:07:22] Speaker A: Yeah, that could be a pretty telling question.
[00:07:27] Speaker B: It can be.
And we get so many different variations of answers.
[00:07:35] Speaker A: We also do a student interview. So in addition to gathering that background information, we do an interview directly with the student. So we ask them questions. We usually have them write and speak their answers. So we might ask them, what's your favorite color? And we might have them write them down. And we can really get a lot from that spontaneous writing sample. If they're not able to spell their favorite color or their favorite sound season, it does. It can tell us a lot. Depends on the age of this child, too, that we're testing.
And then to say probably child today. But understand we do diagnose adults here. I just want to make that kind of clear.
[00:08:24] Speaker B: And just for those questions, too. Sometimes you can tell that they're writing answers. They do know how to spell.
[00:08:30] Speaker A: Yes.
[00:08:32] Speaker B: And not telling you what is actually their favorite thing because that would be too difficult for them to spell.
[00:08:38] Speaker A: And a lot of times what you get from them orally. Right. I will ask them some questions that they just answer orally and they might give me kind of a lengthy, detailed answer. But then if I ask them to write something down, it's going to be something much shorter, maybe only one or two words. They might not be using complete sentences.
That's going to tell me on an informal way.
I think there might be some kind of gap between the oral language abilities and these written abilities. So it's a good way to start these assessments. And usually it's also a good way to get that student, whoever is in front of us, getting a little bit more comfortable in the environment because we're going to be asking them to do some really hard things.
[00:09:31] Speaker B: Correct.
And then also written language skills. We also review the Alphabet knowledge. So ABC order, including, like identification of letter names, upper and lower case letters. We have them write them. We also have them Write the numbers 1 through 10, because math is definitely impacted a lot with dyslexia. And it's a good way to see if maybe they have all their Numbers, but they can't get all the letters and vice versa. And you can also see reversals in both things. So.
[00:10:12] Speaker A: Absolutely.
Some listeners may be a little bit surprised to hear that. Generally we're asking everybody who comes to see us for an assessment, all the way from pretty, pretty little, we'll do an assessment on a four year old. I mean four is kind of the earliest we would do a full on diagnosis of dyslexia. But even the adults who come to us for an assessment, we are asking them for this kind of sample.
[00:10:46] Speaker B: And it's very interesting sometimes.
[00:10:47] Speaker A: It's very interesting sometimes.
[00:10:50] Speaker B: And then with older students or adults, we might do like a free writing sentence or a paragraph just to kind of see what their baseline kind of is.
[00:10:59] Speaker A: You might want to see, are they, do they have those kind of basic conventions? Are they capitalizing? Are they using punctuation?
Does their sentence or paragraph make any sense?
[00:11:12] Speaker B: Correct.
And then when we go back to littles like the four to six year olds, we also do some book handling knowledge, which basically means we give them a book. Where's the title? Where's the author? How do you open the book? Where do you start reading? On a page? Where's the end of the page? How do you turn a page? Just kind of getting their knowledge of how does a book actually work?
[00:11:38] Speaker A: Mm, yeah. Sometimes we have those guys right there might be holding a book upside down, back to front reading, don't understand directionality too. That left to right, I might have them run their finger. Okay, where would I start reading on this? Yes. And that will, that can tell me a lot about those pre literacy skills, you know, and I too sometimes people think like, well, if they've been read to a lot, they'll know how to handle a book. I have found that not necessarily to be true.
[00:12:17] Speaker B: Yeah.
[00:12:17] Speaker A: Some of our littles that do get read to a lot still really don't have that awareness of how to actually handle a book.
[00:12:28] Speaker B: Exactly.
And then usually after this, we start into the standardized testing.
[00:12:35] Speaker A: Yes. Everybody's favorite part, right? Nobody's favorite part. Including mine.
[00:12:39] Speaker B: Yeah, I like standardized testing, but that's based on the person, I think.
[00:12:46] Speaker A: Yeah, yeah, yeah.
[00:12:48] Speaker B: It really depends on the age and what the students have already had for standardized testing, what we use. Because schools sometimes test for certain things and so we tend not to use the same things that the schools have with a standardized test. You should not be giving them back to, back or in the same. Sometimes it's like a year to five years. You're supposed to have a Break between giving them. Because then it. It takes away the validity of the data. Because they could remember some of the answers.
[00:13:21] Speaker A: Exactly.
[00:13:21] Speaker B: So you don't want to give the same test. So we do typically do not do the same test that a school would do.
[00:13:27] Speaker A: Yes, especially. Or if they've had a recent neuropsych eval.
A typical way somebody maybe finds us for an assessment is that they have actually had a neuropsych evaluation and it's been fairly recent. But that neuropsych evaluation didn't get into the nitty gritty of dyslexia. And so we want to see that report and make sure we're not repeating a test that a neuropsych just did. Because we want to make sure our data is valid.
[00:13:58] Speaker B: Yes.
So we use a variety of different standardized tests, and not every assessment is exactly the same that we use for every person based on their age, grade, all sorts of things.
[00:14:12] Speaker A: So we're going to walk you guys through the skill areas that we test without really necessarily giving the exact name of the specific testing measures that we do, because that may look different based on who's coming in our door.
[00:14:31] Speaker B: There's certain tests that we can only use for certain ages.
[00:14:35] Speaker A: Yes.
[00:14:35] Speaker B: But then there's another test for. That has the same kind of content in for a different age group. So that's why we're doing it by skill set versus actual testing.
[00:14:49] Speaker A: Yes.
So some skills that we would take a look at.
So we're going to look at something called sight word efficiency. This is the speed and accuracy of reading common sight words. These may be irregular words. They may. They may not be, but they're going to be common words that are used frequently.
[00:15:14] Speaker B: Like the. And at. Like love those type of things.
[00:15:21] Speaker A: Exactly.
So that's going to measure for both speed and accuracy.
[00:15:27] Speaker B: Correct.
[00:15:28] Speaker A: And then we're also going to measure decoding efficiency. Decoding efficiency is the speed and accuracy of reading nonsense words that are unfamiliar to that student. So the student now has to apply their own decoding knowledge to this task. And again, that is speed and accuracy.
[00:15:53] Speaker B: And students with dyslexia often show a discrepancy between these two skills. They can memorize common words pretty easy sometimes, not all the time, but a lot of the time.
But when they get to that decoding part, you can really see a big difference between the two.
[00:16:11] Speaker A: Yes. The other thing that we might see here, I like having a very direct. The test we usually use for this has it directly compared, which I like a lot.
It also can tell me sometimes Students actually score higher on the decoding efficiency than they do on the sight word efficiency. And that can tell me that usually that kid is an impulsive student. That student is looking at maybe the first letter of those common sight words and just taking a guess and moving on without actually decoding. So that actually this direct comparison as a person who does these assessments tells me a lot about the learning profile of this student.
[00:16:59] Speaker B: And if both are low, sometimes that can show us that that orthographic mapping is not happening for that student. So that's the way that our brain gets those common words in our head so that we don't have to read those words.
[00:17:15] Speaker A: Yes.
[00:17:16] Speaker B: Or decode those words every time we see them. Like the word. The. We don't have to go.
Every time that we see it. We know it's the.
[00:17:24] Speaker A: Exactly. Having that, you know, word picture basically in our mind.
[00:17:29] Speaker B: Correct.
[00:17:30] Speaker A: And the goal really of any word is for it to be considered a sight word at some point.
We don't want to spend all of our time decoding.
[00:17:40] Speaker B: Exactly. Because that takes longer. And then you're working so hard to decode, you can't understand what you're reading.
[00:17:46] Speaker A: Exactly.
[00:17:48] Speaker B: So then we look at phonological and phonemic awareness skills. So as a reminder, we did a whole episode on this. These are the skills that involve identifying and manipulating the sounds in words.
[00:18:03] Speaker A: Yes.
So some different skills that we test that would all kind of go under that phonological awareness umbrella.
We do a measure of elision, which means that we would give a word and then we would have a student delete a sound in a word. So really, that's kind of like a deletion task.
We would also do a segmenting task. So we would have the student, I would give them a word, and I might have them break it up into syllables or sounds.
Then we would also do a blending words, where we would give them the sounds or syllables, and they would have to blend it together.
Also included kind of on that phonological awareness part is phoneme isolation. So I would give them a word and. And I would ask them to give me either the first sound in the word, the last sound in the word, or the middle.
Or in a more advanced situation, it could be even the second sound in a four sound kind of word. Yeah.
[00:19:19] Speaker B: And then we look at phonological memory. So these tests kind of look at the memory. So, like, memory for digits. We give them digits that increase over time from like maybe two digits to three digits to four digits, and then they have to repeat it immediately.
Memory for words. Same thing. We give them one word, then we give them two words and then three words and they have to remember these. Now this could be forwards or backwards for either of these.
[00:19:50] Speaker A: Yes.
Often a test is going to include include them both.
[00:19:55] Speaker B: Correct.
[00:19:56] Speaker A: Which is always really interesting.
[00:20:01] Speaker B: Yes, very interesting.
And that's still. It's also could be called digit span. Forwards or backwards. It's the same type of thing.
[00:20:10] Speaker A: Yes.
Often too, we'll do a non word repetition subtest where we'll say a nonsense words and the student will have to repeat that nonsense word back to us exactly as they heard it.
This can really tell us a lot about sometimes this tells us about articulation and kind of their phonological abilities in general. But this can also tell us specifically with blends. Right. Like, oh, okay, this kid is kind of hearing only one sound in this blend or they're really only producing it back to me. And it's a more simplistic version of the word.
[00:20:57] Speaker B: And when they get to multi syllable non words, you can tell sometimes that they're not holding on the beginning of that word.
[00:21:05] Speaker A: Yes.
[00:21:05] Speaker B: By the time they get to the end. And so that's a big red flag there too.
[00:21:10] Speaker A: Yes.
[00:21:13] Speaker B: Rapid symbolic naming is basically saying numbers and letters and seeing how long it takes them to say a bunch in a certain amount of time. Usually it's a minute or two minutes, depending on the test.
And that's kind of seeing how fast their brain is being able to pick up. Oh, that's an A, that's a T, that's a G.
So that you can kind of see how fast their brain is able to process that.
[00:21:40] Speaker A: Yep. We use a couple of different measures for that Rapid symbolic naming. Sometimes we do say that Rapid automatic naming and we shorten that to ran. This is this. We're testing something very similar here.
[00:21:55] Speaker B: Correct.
[00:21:57] Speaker A: One of the tests that we typically give have letters and numbers that really don't look much alike at all. They're just kind of the most common letters and they have them repeated a bunch of times. And then another one that we do give gives very close distractor letters is what we're called.
[00:22:16] Speaker B: So pq.
[00:22:18] Speaker A: Yes.
[00:22:20] Speaker B: Nu. Those type of things.
[00:22:22] Speaker A: Yes. Yep. That's something too. We take a look at when we're comparing the two measures of rapid automatic naming that we're going to give, is there a significant discrepancy between those two things that can, that can give us some additional information?
[00:22:41] Speaker B: Correct.
And then most of the assessments have some sort of vocabulary awareness. Sometimes it's in pictures. Sometimes it's orally. Sometimes they have to read a question and be able to answer it based on the vocabulary word.
Depending it's based on age, pretty much of which one you get.
But it's very important to know what their vocabulary is and if there's a difference between vocabulary and what they're able to decode.
[00:23:09] Speaker A: Yes.
[00:23:13] Speaker B: Also orthographic processing. So this is being able to read and spell words and non words.
How are they doing with reading those words and non words or nonsense words and spelling both. Because you can really kind of see a difference of if they've memorized a bunch of real words versus if they get a word that maybe it always follows a spelling pattern. But are they able to actually spell them or read them?
[00:23:45] Speaker A: Yes.
That's always a very telling. Yeah, we use multiple measures to get at orthographic processing.
Often that's kind of what's called like a composite.
[00:23:59] Speaker B: Right.
[00:24:00] Speaker A: Score. We're going to kind of get into what that kind of thing means in a later episode. So the other measure we always want to make sure that we are taking a look at is reading fluency.
So reading fluency involves both speed and accuracy.
[00:24:26] Speaker B: Right.
[00:24:27] Speaker A: So we're looking at the average word correct per minute that a student can read.
We are measuring that at their current grade level, if we have that available.
[00:24:43] Speaker B: Yes.
[00:24:44] Speaker A: So we are using a measure that is at their current grade level when we're looking at their reading fluency for diagnostic purposes.
[00:24:54] Speaker B: Correct.
And then we do listening comprehension. So you either telling a story or reading them a story and having them be able to retell it, or that's one way to do it, or have little stories, and then they have to answer questions about it, remembering what happened in the story.
It's really important to see if there's a difference between listening comprehension and reading comprehension, which is what we go into next. We do reading comprehension. So they read a story, they answer questions on it, or they read questions and have to tell us what it means. There's different things that. Different ways that the tests kind of work it out.
[00:25:47] Speaker A: But yeah, when we're seeing a very significant discrepancy between listening comprehension and reading comprehension, that really is telling us that it's that reading piece.
[00:25:58] Speaker B: Right.
[00:25:59] Speaker A: It is not that their brain is not processing information. It is. It's just that that that reading part is something is interrupting their ability to comprehend through reading.
[00:26:13] Speaker B: Correct.
[00:26:14] Speaker A: We also might just do a straight story recall where we tell a student a story and they must tell it back to us exactly as we Told it to them. We're looking at, does this student remember details? And also can they retell it in the correct order?
Students with dyslexia tend to also have trouble with C sequencing. And so they could maybe remember some of these details, but it's kind of like their stories don't always make sense. And they have trouble with that sequencing part, which, you know, gets at executive functioning as well.
[00:27:01] Speaker B: Correct.
[00:27:01] Speaker A: Which is an area impacted by dyslexia.
[00:27:05] Speaker B: Yes.
Following directions. That's another thing that we also do in a lot of the subtests because, you know, orally, they're following the directions either with their pencil or verbally, and those type of things also. Look at that. Oral language again.
[00:27:26] Speaker A: Yes. Yes.
Yeah. Usually that test, there's a couple of different ones that we use, but they're giving them usually some pictures, and they're following directions with, like, a pen or a pencil. And they start out pretty.
One step, one step, two steps, and very, very clear. And then they get a little bit more squishy. Like, after you circle the sun, put an underline under the B, or if the arrow is pointing down, circle the X. You know, those things that. Oh, now we have to process multiple things and use language to figure out what we're even supposed to do.
[00:28:13] Speaker B: Correct.
And then we do written expression. We look at the spelling, this discourse, and the semantics. So we make sure that there's capitalization, punctuation.
Does the sentences make sense?
Depending on the directions of the written expression subtest. Did they follow them?
[00:28:34] Speaker A: Yes.
[00:28:37] Speaker B: So that's all something that we look at with those written skills.
[00:28:43] Speaker A: Yeah. So the way that we do assessments at DAC is that we use more than one measure to get an accurate picture. So all of those skills that we listed for most of them, we are using more than one subtest to take a look at all of those skills, because our students.
Man, those students with dyslexia, I will tell you, are so smart. They use different strategies, and they could often guess very well. A lot of our students with dyslexia are actually pretty good people. Readers. And they can kind of read your face, and they know what you want from them, and they are kind of wanting to please you.
[00:29:32] Speaker B: Correct.
[00:29:32] Speaker A: So that's one of the struggles. I think, as somebody who does both intervention and assessments, it's hard to kind of. I really have to, like, I have my assessment hat on right now. I'm not teaching right now. I'm assessing because it can be really hard not to try to jump in. I mean, I've had, I'm at this a really long time now. I don't jump in or do any of that anymore.
But there's a reason, you know, you have to be trained to do these assessments and they know what, they know what is being asked of them. And it's hard sometimes to get a really accurate picture.
[00:30:19] Speaker B: And I think too, they're really smart in the way that they problem solve what the answer could be yes. So like you're asking them a question, they're like, well, logically I can say this and then it'll work. And it does. And so then that's why we use a variety of assessments, not just one, because sometimes some are a little bit more the. Where they're structured. They can't guess the sequence or they can't guess it as well. So. And we don't know which one that they can do. So then that's why we use a variety.
[00:30:56] Speaker A: Exactly right. Because, I mean, it's not consistent across.
Across the. Across the students that we see here.
[00:31:06] Speaker B: Correct.
[00:31:07] Speaker A: So it's really important to us.
Kind of part of our, I guess, mission and vision at DAC is that we're giving a very robust assessment that somebody can pick up and actually get information from.
[00:31:25] Speaker B: Correct.
[00:31:26] Speaker A: We are going to be talking in next episode about how to read an assessment report because they can be very, very hard to read. And so it's really important to us that we kind of pride ourselves that our assessments are, we hope. Right. Easier to read for anybody. They're not only geared to a doctor or only geared to a psychologist.
They have a wide audience and we just want to be very accurate. That at the end of the day, that's the point of the assessment, that's what a parent is looking for, is an accurate reflection of the learning profile of the kid that's in front of us.
[00:32:17] Speaker B: Correct. And that's why we also at dac, we have an assessment team. We look at the evidence.
We meet monthly because we do feel that evidence changes fast. And so we want to make sure that we're still using assessments that are evidence based and that are getting to the subtest. We really want to.
[00:32:39] Speaker A: Yeah, exactly. And if we have a question about an assessment, we will bring it to the team.
And that's, I think, something that makes us stand out a lot.
I really don't know of any other place that does that. The way we do that. We're. We make clinical decisions both individually but also as a team, which really helps keep our practitioner skills really sharp.
[00:33:11] Speaker B: Correct.
So, Maggie, what's happening outside dyslexia.
[00:33:16] Speaker A: Yeah. So it is. As we record this, we have survived spring break. So we are on the home stretch of this school year.
We are looking forward to summer. We're kind of starting to do some summer planning. My kids are going to do summer school this year, which they have not done in the past.
[00:33:38] Speaker B: Okay.
[00:33:39] Speaker A: But they are excited about it. They have a lot of really fun offerings. And so our school district makes it really accessible to do summer school. There's no feature for summer school except for some of the classes have like a $5 material fee, which. Yeah, no problem. That's fine.
So we're, we're looking forward to that. That's a new change for us.
What's going outside of dyslexia with you, Nicole?
[00:34:12] Speaker B: Lots of stuff. Always lots of stuff. But I think the most exciting news is we've Dyslexia Achievement center has partnered with a nonprofit. So we finally got to start our Read and Succeed project. So we now can take donations and apply for grants to help our families pay for structured literacy interventions and the assessments that we give here. So that's been a five year work that we've put into.
[00:34:41] Speaker A: That's been a long standing goal and we're so excited about it.
Well, thank you everybody for listening. If you like our show, please follow us on social media and reach out to us if you have any questions or would like us to discuss a topic. If you do like our show, please be sure to follow and rate our show on your favorite podcast player. That's really how we reach more listeners and that's how we get to help more families. Thank you, everybody.
[00:35:14] Speaker B: Thank you.
