Presentation on theme: "Advanced Cross-Battery Assessment Using CHC Theory and Neuropsychological Measures Catherine A. Fiorello, Ph.D., ABPP Temple University September 30, 2011."— Presentation transcript:
Advanced Cross-Battery Assessment Using CHC Theory and Neuropsychological Measures Catherine A. Fiorello, Ph.D., ABPP Temple University September 30, 2011
Workshop Objectives Participants will be able to: Use XBA to detect processing deficits in identifying students with LD and ADHD Describe how processing assessment can be integrated within an RtI model Understand how CHC Theory and neuropsychological assessment work together
Cognitive Product or Process: Synthesizing Paradigms Compares individual to norm Focuses on score: Assessment Product Interpret levels of performance Compares individual to self Focuses on performance: Assessment Process Interpret patterns of performance Nomothetic Assessment Idiographic Assessment BOTH essential for effective assessment and intervention
IDEA 2004: The Impetus for Developing Better Assessment and Intervention Strategies
Identifying Children with Learning Disabilities: IDEA Definitions and Practices Learning Disabilities is a disorder of one or more of the basic psychological processes that adversely affects educational achievement in one or more academic domains Defining Learning Disabilities Discrepancy between “ability” and “achievement” (typically using cut-off points and global IQ) Failure to respond to scientific research-based intervention May permit the use of other alternative research-based procedures for determining whether a child has a specific learning disability, as defined in §300.8(c)(10) (OSERS Final Regulations-8/06) Determining Learning Disabilities
RtI as Prereferral Process Prereferral interventions, with good progress monitoring, are essential to serving children. Interventions may help a large number of children (e.g., Torgeson, early reading, 94- 96%). Tracking response to intervention provides good information about what works and what doesn't. Avoids “waiting to fail.”
Problems with RtI Established interventions for many referral problems do not exist. Agreement on goal setting (what is failure to respond?) can be problematic. Many children are referred for multiple areas of difficulty. Failure to respond may be due to many reasons other than disability.
RtI and LD RtI provides valuable information as part of an evaluation for learning disabilities A failure to respond to interventions is not, by itself, diagnostic of a learning disability. Cognitive and neuropsychological processing is critical to identifying LD. School psychologists can and should evaluate processing.
~85% ~10% ~3 % ~2% Protocol-based interventions Personalized interventions IEP Universal screening Individual screening Comprehensive assessment: cog/neuro/ach ecobehavioral personality etc. High quality research-based teaching Fiorello Comprehensive RTI Model
Cognitive Hypothesis Testing Model Source: Hale, J. B., & Fiorello, C. A. (2004). School Neuropsychology: A Practitioner’s Handbook. New York, NY: Guilford Press. Theory Hypothesis Data Collection Interpretation 1. Presenting Problem 2. Intellectual/Cognitive Problem 3. Administer/Score Intelligence Test 4. Interpret IQ or Demands Analysis 5. Cognitive Strengths/Weaknesses 6. Choose Related Construct Test 7. Administer/Score Related Construct Test 8. Interpret Constructs/Compare 9. Intervention Consultation 10. Choose Plausible Intervention 11. Collect Objective Intervention Data 12. Determine Intervention Efficacy 13. Continue/Terminate/Modify Implications for Assessment and Intervention
Processing and LD Literature in cognition, cognitive assessment, neuropsychology, and learning disabilities links cognitive processing with achievement and LD. Regular education curricula tend to focus on a few areas of processing (e.g., phonemic awareness) to the exclusion of many others. Once there has been failure to respond, process assessment can be used to develop interventions.
School Neuropsychology: The Key to Reconceptualizng Cognitive Processes for Assessment and Intervention
The Two Axes Interpretation Posterior -Sensory Input -Comprehension Anterior -Executive Functions -Motor Output
Structural Hemispheric Differences More Grey Matter More White Matter More Primary Cortex More Association Cortex Left Hemisphere Right Hemisphere More Intramodal Connections More Intermodal Connections Source: Goldberg, E., & Costa, L. D. (1981). Hemispheric differences in the acquisition and use of descriptive systems. Brain and Language, 14, 144-173.
The Two Axes Interpretation Posterior -Sensory Input -Comprehension Anterior -Executive Functions -Motor Output Left Hemisphere -Routinized/Detailed/Local -Convergent/Concordant -Crystallized Abilities Right Hemisphere -Novel/Global/Coarse -Divergent/Discordant -Fluid Abilities
Is There Evidence? Newborn language processing Musician processing of symphonies American Sign Language in the deaf Brain activation in novice-new learning vs. expert-learned Bilateral fMRI activation: Left and right for Verbal; Right and left for nonverbal processing Source: Hale, J. B., & Fiorello, C. A. (2004). School Neuropsychology: A Practitioner’s Handbook. New York, NY: Guilford. Psychological processes matter more than stimulus input or response output!
Hemispheric Functions and Language Left Hemisphere Right Hemisphere Low DemandHigh Demand Source Belger & Banich, 1998 Local/DetailedGlobal/HolisticDelis et al., 1986 MicrostructuralMacrostructuralGlosser, 1993 Fine ProcessesCoarse ProcessesBeeman/Chiarello, 1998 Close Semantic Distant SemanticChiarello, 1998 Concordant/ Convergent Discordant/ Divergent Bryan & Hale, 2001 Simple Syntax Complex SyntaxCooke et al., 2001 Routinized/AutomaticNovel/New LearningGoldberg/Costa, 1981
Comprehensive Assessment Model STUDENT HOMESCHOOL COMMUNITYPEERS Instruction Interventions Structure Supports Services Family Constellation Siblings Attachment Parental Mental Health Parental Educational Background Resources Economic Resources Social Resources Role Models Violence Friendship Role Models Bullying Social Skills Vocational Interests Academic Skills Study Skills Adaptive Behavior Developmental Status Physical Health Cognitive Abilities Emotion Regulation Psychopathology Language History Language Development Background Knowledge Motivation
The Neuropsychology of Reading Disorders Phonological Awareness Symbolic Representation Phoneme-Grapheme Correspondence Timing/Automaticity Word Attack vs. Sight Word Strategies Semantics Syntax Pragmatics Timing/Automaticity- Fluency Explicit-Factual vs. Implicit-Inferential Comprehension Word Recognition Reading Comprehension Double-Deficit or multiple subtypes? Source: Hale, J. B., & Fiorello, C. A. (2004). School Neuropsychology: A Practitioner’s Handbook. New York, NY: Guilford.
The Neuropsychology of Math Disorders Quantitative Knowledge Value-Grapheme Correspondence Sequential/Working Memory Visual-Perceptual- Spatial (higher only) Graphomotor Auditory Processing Verbal Comprehension Quantitative Knowledge Word/Symbolic Representation Sequential/Working Memory Fluid/Quantitative Reasoning Computation Word Problems Source: Hale, J. B., & Fiorello, C. A. (2004). School Neuropsychology: A Practitioner’s Handbook. New York, NY: Guilford.
Developing and Testing Hypotheses About Cognitive Processes and Achievement Examine profile for significant subtest or factor scatter If global scores are invalid, interpret subtest performance within and between subtests Use Demands Analysis to examine Input, Processing, and Output Demands (Caution: Processing Demands More Relevant) Demands Analysis is prone to error, must validate with additional measures (Caution: Avoid Cookbook Interpretation) Data must show convergent, divergent, AND ecological validity
CAS, cont. Attention Expressive Attention Glr:NAInhibition of automatic response; similar to Stroop Number Detection Gs:PCancellation task, sustained attention, visual scanning, visual discrimination, inhibition, psychomotor speed Receptive Attention Gs:PSustained attention, visual scanning, attend to perceptual, then shift set to meaning Successive Word SeriesGsm:MSWord span, rote auditory memory Sentence Repetition Gsm:MS Gc:MY Rote recall of meaningless sentences, grammatical structure important Sentence Questions Gsm:WM Gc:LD Language comprehension based on grammatical structure with meaningless content Speech RateGps:PTOral praxis
WISC-IV Integrated Verbal Comprehension Verbal Subtests Multiple ChoiceLong-term memory retrieval; compares free-recall and recognition memory Working Memory Visual Digit Span (Forward)Compare visual to auditory memory span Spatial Span (Forward and Backward) Compare visual to auditory working memory Letter Span (Forward)Compare numbers to letters (familiarity) L-N Seq Process Approach Arithmetic Process ApproachCompare working memory effects Written ArithmeticCompare arithmetic knowledge
WISC-IV Integrated, cont. Perceptual Reasoning Block Design Multiple Choice Visual discrimination and spatial perception; removes v-m integration and speed demands Block Design Process Approach Comparison of orientation (LH) versus configuration (RH) errors Elithorn MazesExecutive funtions—planning, organization, monitoring, inhibition; graphomotor skills Processing Speed Coding CopyVisual-motor integration, graphomotor skills, processing speed Coding RecallPaired-associate symbol and digit recall, free recall
CMS Auditory/Verbal StoriesGlr:MMAuditory attention, semantic long-term memory encoding and retrieval, sequencing/grammar, verbal comprehension, expressive language Word PairsGlr:MAPaired-associate task; auditory attention, learning novel word pairs Word ListsGlr:M6Selective reminding task; long-term memory encoding, storage and retrieval of unrelated words Visual/Nonverbal Dot LocationsGv:MVVisual-spatial memory encoding and retrieval (dorsal stream); susceptibility to interference FacesGv:MVFacial memory encoding and retrieval (ventral stream) Attention/Concentration SequencesGsm:WMRote recall followed by mental manipulation-- executive function (working memory)
NEPSY-II Executive Functions/Attention Animal SortingGf:IProblem-solving, verbal and spatial concept formation, categorical thinking, flexibility of thinking Auditory Atten & Response Set GsSustained auditory atten., vigilance, inhibition, set maintenance, flexibility ClocksGv:Vz Gc:K0 Telling time, reading analogue clocks, visual-spatial processing, graphomotor Design FluencyGlr:FFVisual-motor fluency, flexibility, divergent thinking, graphomotor InhibitionGlr:NANaming fluency, inhibition, shifting set Knock and TapGsm:WMSelf-regulation, inhibition, maintaining set StatueResistance to distraction, inhibition, motor persistance
NEPSY-II, cont. Language Body Part NamingGc:K0Knowledge of body parts, receptive and expressive Comprehension of Instructions Gc:LSReceptive language, sequencing, grammar Oromotor Sequences Gps:PTOral praxis, sequencing, memory span Phonological Processing Ga:PCAuditory attention, phonological awareness, segmentation, assembly Recognition of Reversals Gv:MV Gc Visual perception of orientation, orthographic knowledge Repetition of Nonsense Words Ga:UM Gsm:MS Phonemic awareness, auditory memory span, sequencing Speeded NamingGlr:NANaming automaticity, processing speed Word GenerationGlr:FWVerbal fluency, integrated RH/LH functioning, compare category with letter responses
NEPSY-II, cont. Sensorimotor Functioning Fingertip TappingGps:MTSimple motor speed, perseverance Imitating Hand Positions Gp:P2Visual perception, praxis, kinesthesis Manual Motor SeriesGpImitate a series of rhythmic movements Visuomotor Precision GpVisual-motor integration, graphomotor w/o construction Social Perception Affect RecognitionGkn:BCFacial processing (ventral stream), matching emotions Theory of MindGkn:BCPerspective taking for knowledge and emotions
NEPSY-II, cont. Visuospatial Processing ArrowsGv:SRSpatial processing, visualization, line orientation, inhibition, no motor Block Construction Gv:VzVisual-spatial processing, constructional praxis, planning, bimanual coordination Design Copying Gv:VzVisual-motor integration, graphomotor skills, local and global processing Geometric Puzzles Gv:VzVisual-spatial processing; figural, mental rotation, no motor demands Picture Puzzles Gv:CF Gc:K0 Visual-spatial processing, pictorial, visual discrimination, local detail processing, figure-ground Route FindingGv:SSVisual-spatial processing, orientation
NEPSY-II, cont. Memory and Learning List Learning (Delay)Glr:M6Verbal memory Memory for Designs (Delay) Gv:MVVisual memory, spatial recall and visual details Memory for Faces (Delay) Glr:MAFacial memory (ventral stream) Memory for Names (Delay) Glr:MAAssociative memory, names and faces Narrative MemoryGlr:MMMeaningful memory Sentence RepetitionGsm:MS Gc:LD Auditory short-term memory, content and grammatical structure important Word List Interference Gsm:WMAuditory memory, short term and working memory (with interference)
D-KEFS SortingProblem-solving, verbal and spatial concept formation, categorical thinking, flexibility of thinking Trail MakingMental flexibility, sequential processing on visual-motor task, set shifting Verbal FluencyVerbal fluency Design FluencyVisual fluency Color-Word Interference Attention and response inhibition TowerPlanning, flexibility, organization, spatial reasoning, inhibition 20 QuestionsHypothesis testing, verbal and spatial abstract thinking, inhibition Word ContextDeductive reasoning, verbal abstract thinking ProverbMetaphorical thinking, generating versus comprehending abstract thoughts
Tests Discussed CMS Children’s Memory Scale PsychCorp/Pearson CAS Cognitive Assessment System Riverside CTOPP Comprehensive Test of Phonological Processing Pro-Ed DAS-II Differential Abilities Scales Second Edition PsychCorp/Pearson D-KEFS Delis-Kaplan Executive Function System PsychCorp/Pearson KABC-II Kaufman Assessment Battery for Children Second Edition Pearson Assessments NEPSY-II PsychCorp/Pearson WISC-IV Integrated PsychCorp/Pearson