Cognitive Interventions for Academic Difficulties (part 3)

Cognitive interventions for academic difficulties (part three of a three part series)

This week is the final instalment of my series on cognitive interventions for academic problems. As an educational psychologist working in Hong Kong with a lot of children that have developmental difficulties such as dyslexia, ADHD and autism spectrum disorders it’s important to keep up with research on various interventions as many of these children have academic difficulties. Below is a discussion of the implications of the research that has been reviewed in part one and two.

Implications

Over 200 studies synthesized in seven meta-analyses found a negligible to small effect for cognitive assessments and interventions on reading and mathematics performance improvements. There were a few clear implications of these data. First, working memory interventions do nothing to improve reading or mathematics skills. Although books and conference sessions profess that they do, there is not convincing evidence to support using working memory interventions for reading or mathematics. A second clear implication is that IQ and other measures of cognitive functioning might correlate well with reading and mathematics achievement, but they correlate poorly with student response to intervention. In other words, IQ tells us how much a student knows within the range of developmentally typical   intelligence (i.e., child does not have cognitive disability),but IQ tells us very little about how well a student will respond to intervention. Practitioners should not use IQ to triage student need or to determine which interventions are appropriate for individual students. What is the harm in using cognitive measures to inform intervention? The data from these 200 studies suggest that examining cognitive processing data does not improve intervention effectiveness and doing so could dis- tract attention from more effective interventions. Unfortunately, educators often have a fascination with that which is new, so much so that “brand- new mediocrity is thought more of than accustomed excellence” (p. xi, Ellis, 2001). School psychologists may turn from effective interventions such as explicit instruction (d = 0.84;Kavale&Forness,2000),teaching reading comprehension strategies (d = 1.13; Kavale&Forness,2000),and repeated reading (d = 0.83 for fluency and d = 0.67 for comprehension; The rrien,2004) in favor of interventions that have strong intuitive appeal but little to no research evidence.  School psychologists should help school personnel stay focused on that which we know works.

References

 

Burns, M. K., Petersen-Brown, S., Haegele, K., Rodriguez, M., Schmitt, B., … VanDerHeyden, A. M. (in press). Meta-analysis of academic interventions derived from neuropsychological data: Further evidence for a skill-by-treatment interaction. School Psychology Quarterly.
Kearns, D. M., & Fuchs, D. (2013). Does cognitively focused instruction improve the academic performance of low-achieving students? Exceptional Children, 79, 263–290.
Melby-Lervag, M., & Hulme, C. (2013). Is working memory training effective? A meta-analytic review. Developmental Psychology, 49,270–291.
Scholin, S., & Burns, M. K. (2012). Relationship between pre-intervention data and post-intervention reading fluency and growth: A meta-analysis of assessment data for individual students. Psychology in the Schools, 49, 385–398.

Schwaighofer, M., Fischer, F., & Buhner, M. (2015). Does working memory training transfer? A meta-analysis including training conditions as moderators. Educational Psychologist, 50, 138–166.

Stuebing, K. K., Barth, A. E., Mofese, P. J., Weiss, B., & Fletcher, J. M. (2009). IQ is not strongly related to response to reading instruction: A meta-analytic interpretation.
Exceptional Children, 76, 31–51.

Stuebing, K. K., Barth, A. E., Trahan, L. T., Radhika R. R., Miciak, J., & Fletcher, J. M. (2015). Are child cognitive characteristics strong predictors of responses to intervention? A meta-analysis. Review of Educational Research, 85, 395–429.

 

Effectiveness of Cognitive Processing Assessments and Interventions

Effectiveness of Cognitive Processing Assessments and Interventions on Academic Outcomes: Can 200 Studies be Wrong? (part 1 of a 3 part series)

As an educational psychologist working in Hong Kong parents and school staff often seek information on what sort of interventions may be helpful for their children or students academic difficulties. This includes children with ADHD, Dyslexia and Autism Spectrum Disorders (including Aspergers Syndrome). Schools in particular look for guidance in implementing Multi tiered support systems that involve various interventions and are part of a response to intervention (RTI) process. The use of research based interventions with some validity is an important part of the RTI process. In this series of three weekly blogs I will analyse and summarize a number of pieces of current research on cognitive processing assessments and interventions to help children develop academic skills. The first part will be an introduction, the second a look at the data and the third blog will explore the implications of this research.

The current national implementation of response-to-intervention frameworks in the USA has intensified the debate regarding underlying causes of student deficits and how to best assess and intervene for them. Several scholars have advocated for using measures of cognitive processing to analyse academic difficulties and design individualized interventions(e.g., Feifer, 2008; Fiorello, Hale & Synder, 2006; Floyd, Evans, & McGrew, 2003; Hale, Fiorello, Bertin, & Sherman, 2003; Hale, Fiorello, Kavanagh, Hoeppner, & Gaither, 2001). Feifer (2008) proposed using measures of underlying cognitive abilities for the purpose of selecting interventions and recommended several contemporary tests of intelligence, memory, and executive functioning to do so. There are also multiple resources available to school psychologists that describe interventions based on remediating underlying cognitive deficits. For example, there are books that list general reading interventions based on neuropsychology (Feifer & De Fina, 2007) and interventions for specific cognitive processes such as working memory (Dehn, 2008). Moreover, there were five mini-skills and documented sessions at the 2015 National Association of School Psychologists annual convention that provided free guidance on using data from cognitive measures to remediate reading difficulties, and multiple paid workshops at both the national and summer conferences with similar foci.

Meta analyses were proposed by Gene Class (1976) as a way to synthesize a research literature to better understand its findings. He proposed use of standardized mean differences in which the results of the study would be reported in standard deviation units that represented the difference between the treatment and control group. Cohen (1988) proposed the now famous d statistic, which is the difference of the two group means (control and experimental) divided by the pool standard deviation, and indicated that a d of 0.20 was a small effect, 0.50 was a moderate effect, and 0.80 was a large effect. Other metrics are also used, such as r and r2, but all approaches can be converted to each other for common comparisons.

If cognitive measures are useful to intervention planning, then experimental research should be able to demonstrate that use of cognitively focused interventions generate academic performance gains better than standard instructional practices that can be used in the absence of cognitive processing data (e.g., increasing corrective feedback, improving teacher clarity). Fortunately, there have been several recent meta-analyses regarding the role of cognitive measures to inform academic interventions. Next week a look at the data from these studies.

Helping Children with Reading Comprehension Difficulties (Dyslexia)

BOOK REVIEW: DEVELOPING READING COMPREHENSION P.J.Clarke, E. Truelove, C. Hulme & M.J. Snowing

 

Difficulties with development of reading comprehension are a hallmark of dyslexia. As an educational psychologist working in Hong Kong parents and colleagues often ask for updated information sources for helping children with dyslexia. This recommended book is written by a team of well respected researchers in the field of reading difficulties. It provides a valuable compilation of research and practice in an area currently of concern to many parents and education professionals. As such the strength of the book lies in its well-explained marriage of theory and practice based on solid research field.

 

The authors go on to detail three overlapping intervention approaches (The oral Language program, The Text Level program and the combined program) to improve reading comprehension and an evaluation of their effectiveness. An additional bonus is the wealth of detail provided on the research methodology used to investigate the outcomes of the programs. This enables the reader not only to understand the research methods but also provides valuable information and examples for others who might wish to carry out research of this nature in a ‘real school’ situation. The book reports the highly encouraging findings that reading comprehension can be improved, by any one of the three highly structured intervention approaches detailed in the book. However, it seems to be beyond the scope of the book to clearly recommend one of these approaches although the authors do point out that the benefits of the Oral Language program were the more notable and durable. This draws welcome attention to the importance of developing oral language in schools and this point is clearly made in the final chapter on the theoretical and practical implications. Towards the end, the authors point out that approaches as described might require to be tailored to a particular context, although of course it could not be guaranteed that similar positive results would ensure given modifications.  In any event it is not in the scope of this book to provide detailed daily plans for an intervention delivered over a 20- week period.

 

This book makes a very valuable contribution to the field of reading comprehension intervention and will be greatly appreciated by parents, educators and speech and language therapists working with school age children.

BOOK REVIEW: The Dyslexia Debate

Dyslexia is a general term for disorders that involve difficulty in learning to read or interpret words, letters, and other symbols, but that do not affect general intelligence. It has been the subject of scientific for more than 100 years but its nature and treatments remain debated for educational psychologists all over the world, including Hong Kong. To understand dyslexia, I recommend reading The Dyslexia Debate, 2014 J.G. Elliott & E.L Grigorenko.  

 

Elliott and Grigorenko take on the task of reviewing the field and conclude that ‘the term (dyslexia) has surely outgrown its conceptual and diagnostic usefulness’. Writing the foreword, Vellutino, one of the pioneers of dyslexia research, concurs and prefers to use terms like ‘poor’ or ‘struggling’ readers. The argument that the authors present is that there are no clear cut criteria for dyslexia, there is no cognitive, genetic or neutral evidence that sets those with dyslexia apart form ‘poor readers’, and there is nothing special about the treatments that follow ‘diagnosis’. On the other hand, the authors are clear that there are many children who struggle significantly with learning to read and write and require educational support to prevent a downward spiral of low achievement and poor self esteem. So why not embrace the concept of dyslexia as validated by empirical research, and retain a term that opens the door to intervention for many children and young people?

 

The book continues with the authors presenting their arguments on dyslexia, such as researchers do not agree about the features of dyslexia. However, this begs the question of which researchers and what is the quality of the research they refer to? Unfortunately, too many published studies are not cast within an appropriate developmental perspective, include participants who do not fulfill rigorous criteria for reading disability, which do not report the reliability of their measures. The arguments put forward different perspectives of dyslexia which enables readers to gain an in depth knowledge of the subject.

 

So how can the dyslexia debate be advanced? First we must start by acknowledging where we want to be. Professionals need to be arguing for clarity surrounding the criteria for what dyslexia is and what it is not. Scientists also need to be talking to policy makers about evidence- based approaches to the teaching of literacy, and the characteristics of those who are at high risk of reading difficulties. This will help all children who struggle to respond to quality teaching of reading to be identified and appropriate arrangements made to enable them to succeed.

Assessing language skills in young children

Language and communication skills are essential to children’s ability to engage in social relationships and access learning experiences. Children with autism/asperger’s syndrome as well as Dyslexia may have difficulties with language development. Hence, it is a skill that is often an important part of assessments by Educational Psychologists in Hong Kong in order to determine the developmental progress of a child.

 

In a recent article in the Journal of Child and Adolescent Mental Health. It is found that current screening measures do not meet psychometric pre-requisites (psychometrics = design, administration, and interpretation of quantitative tests for the measurement of psychological variables such as intelligence, aptitude, and personality traits)  to identify language problems. A range of articles is reviewed to identify issues which practitioners and researchers should consider when assessing language skills. There are significant challenges in the interpretation of language assessments, where socioeconomic status, language status and dialect, hearing impairment and test characteristics impact results. The range of articles shows that psychometrically sound assessments of language are an essential component of developing effective and efficient interventions. Regular monitoring of language is preferable, as one- off screening has limited power to predict later performance because children’s developmental paths vary. Hence, a combination of language performance measures is a better indicator of language problems and disorders than single measures of component skills.

 

To conclude, the language system is complex, it composed of a number of subcomponents and the language paths of preschool children vary substantially. As such, the development of reliable and valid assessments is challenging, but they are of central importance for studying typical and atypical development. Research studies continue to enhance our understanding of the language development process and aid our identification of children who experience persistent language disorders and the factors that are associated with these. The assessment of narrative skills and dynamic assessment were highlighted as new developments. The current review has aimed to provide the necessary information to make informed decisions about assessing the language competencies of preschool children.

Dyslexic Children: 7 Important Interventions

Dyslexic children are present in both local and international schools in Hong Kong. Regardless of what language is the medium of instruction in a child’s school some important interventions to consider are as follows:

In general as much work as possible should be adjusted to the child’s rate, capacity and level and include plenty of opportunities for success. He or she should not be continually presented with work that is well above their ability to comprehend.  Teachers should keep things as structured as possible and focus on their achievements and efforts whenever possible. 

Small group and one to one teaching time are essential. Dyslexic children may also have attention problems so working in a smaller group or one to one usually minimizes distractions.

 

When a child is in the 6 to 10 year old range it is usually best to implement an intervention that focuses on development of basic phonics and word attack skills. This will help build the child’s reading vocabulary and increase fluency. Daily drill over a period of 3-9 months or longer is usually necessary and helpful. The intervention time can vary with the chronological and reading age of the child. Examples include “Toe by Toe” and some others that are available at the following website   www.linguisystems.com

 

Extra time to read directions, complete assignments, check written work and take tests should be considered. Completing work in a quiet area may also be helpful. Consider having peer helpers that can read directions to the child.

 

When teachers are probing knowledge of subject areas such as Geography or Science, they could consider letting the child demonstrate understanding by giving verbal answers and/or by using diagrams, charts, graphs or other forms of visual representation. If the child has to demonstrate mastery of concepts in writing it may not be reflective of what they really know.

 

Parents and teachers should encourage the child to develop keyboarding skills. In the long term it will likely be easier for him/her to produce written material on a computer. Utilization of a laptop computer in the classroom on a more regular basis should be considered in the upper years of primary and into secondary school.

 

Read to the child on a regular basis and ask questions about the content as well as having them read words or parts of  passages to assist with development of comprehension skills.  Make weekly trips to the library part of your regular routine and let the child self select reading materials in areas in which they take an interest.