1. Understanding Specific Learning Difficulties: Identification and Diagnosis (Briefing)
June Massey
Intro: Background – I am going to give a short presentation outlining the role and function of the Disability Resource Centre and the services that we provide to both staff and students.
My personal background is in managing learning support and disability support for students with Specific Learning Difficulties, and my teaching specialism is literacy and dyslexia
Disability Resource Centre

2. This session aims to promote an understanding of:
The SpLD assessment process and model
How an SpLD diagnosis is obtained
The time frame for the SpLD diagnostic process
What is the assessment process
Why & how: reasons for the assessment process
When: time frame
Commonly asked questions - why students are assessed/diagnosed for the first time at Uni & can they ‘fake’ the diagnosis in order to get extra time in exams

3. Aims: to address common concerns
Commonly asked questions:
Why are students assessed for the first time at University?
How robust is the assessment process?
Common concerns include: if a student is dyslexic (and so has always been so) why has this not been diagnosed before (i.e. at school)?
Can you fake the assessment in order to get extra time in the exam?
These are questions that you are likely to have been asked and this sessions should help provide you with some responses to these concerns

4. Assessment process

5. What is Dyslexia? Definition (handout) Problems in:
Speed of processing (visual and phonological)
Working memory
Phonological awareness
Deficit model / discrepancy model
Subtle profiles – relative /absolute difficulties
We will use dyslexia as the example of a SpLD, for the purposes of this presentation (the principles apply equally to all of the SpLD’s, but they differ in the details – not enough time to discuss the details of all of them). I will talk you through a typical case of dyslexia, through the assessment process(i.e using a case study). Firstly it would help for you to have an idea of the definition of dyslexia, so you can understand why the questions/tests are conducted – i.e what they are looking for & we will apply this to a specific case.

6. Profile of dyslexia ‘spiky profile’
Relative scores indicative of dyslexia (on handout). If not dyslexic, the index scores across these areas are consistent – in dyslexia there are specific ‘drops’ in the areas of working memory, processing speed and phonological awareness. This can affect reading and spelling attainment (students at Cambridge are less affected by reading and spelling than other dyslexics, as their hgh IQ has brouht these scores up). The reading and spelling problems are only poor relative to their high scores elsewhere – not poor in absolute terms. (i.e they are not as good as they should be, but are o.k for age)

7. Case study – Jane e-mails DRC
Student receives from SpLD administrator with following:
Appointment date (up to 2 weeks) & Confidentiality agreement (disclosure)
Pre-screening questionnaire (self-completion)
Closed questions and narrative responses
Students own description of difficulties/concerns
Referral for eye test
Eliminate eye conditions as reasons for literacy problems
Request for sample of unedited handwritten notes (lecture notes / supervision essay)
Student contacts DRC by as supervisor has expressed concerns about written work (difficulties relative to cohort – not absolute – not so noticed at school with a broader ability cohort)
Pre-screening questionnaire First element of triangulation process (multi-method of data collection) & starts to determine the likely SpLD (i.e dyslexia, dyspraxia, ADHD, etc)
Sample of writing: to consider spelling (when under pressure/ in prose) structure, organization of ideas, expressive language use, letter formation, legibility, consistency & sizing use of margins and writing along a line . This is looking at her difficulties in the context of her course of study & so is ecologically valid.

8. Jane – pre-screening questionnaire
What do her responses indicate at this stage?
Working memory (times tables / sequencing ideas)
Phonological awareness (poor at listening aspect of French, difficulty with new words)
Speed of processing (slow reading, slow writing of ideas)
Refer to definition of dyslexia
Familial history of SpLD (brother, father)
At this stage, just forming general hypothesis. Jane’s responses so far do not describe dyspraxia, ADHD or AS, but are consistent with definition of dyslexia . Screening Interview needed to test this hypothesis

9. Screening interview - purpose
1:1 with SpLD specialist
Structured interview
Questions are trigger points
Looking for patterns consistent with SpLD (or other)
Eliminate other reasons for the difficulties
Norm referenced tests
To support/contradict interview findings
See handout of interview. Why are you asking this questions.
To eliminate other reasons for the difficulties (i.e. medical conditions that cause working memory problems)
To determine a pattern that is consistent with dyslexia (or other )

10. Screening interview – structured questions
Language/listening behaviour
Writing and spelling
Reading
Note-taking
Medical & educational background
Maths
Memory
Spatial/temporal
Visual motor
Not a checklist – ask student to describe how they approach each activity and what they find easy/hard. Looking for a description of problems listening and taking notes in lectures, and note taking from texts, due to poor working memory and processing speed. Good at Maths, but poor at the sequencing aspceys (times tables) and mental arithmetic (again poor working memory and speed of processing)

11. Screening interview – data
Adequate cluster of signs of deficits in:
working memory
Processing speed
Phonological awareness
Select norm referenced tests to test findings:
Speed of reading (TOWRE -SS=89)
Spelling- (WRAT –IV - SS= 105)
Rapid naming (objects and colours) (CTOPP – SS= 85)
The outcome of the interview with Jane indicates a cluster of difficulties in the areas of working memory, speed of processing and phonological awareness. These findings can be tested in order to provide quantitative data to support/refute qualitative. Test behaviour is as important as the test scores.

12. Screening interview – Jane’s outcome
Test results lower than expected
Test results consistent with reported problems in processing speed and spelling
Outcome warrants referral for full diagnostic assessment to EP
Write up outcome of screening interview as short report and pass this to diagnostic assessor (see handout).
The outcome of the interview with Jane indicates a cluster of difficulties in the areas of working memory, speed of processing and phonological awareness. These signs were present throughout schooling (but not enough of a problem). Other possible causes have been eliminated. Therefore it is appropriate to refer on for a full assessment.

13. Full Diagnostic assessment
Appointment with EP – around 2 weeks from referral by DRC (longer if student needs to obtain funding from ALF)
DRC pool of EP’s are quality assured by DRC & liaise closely with DRC Disability Advisers
Student may need to travel to London
Session lasts around 4 hours & Costs £400
Payment needs to be made on the day, so student needs to have the funding ready. This can delay appointment date. Cost is £400. this represents 4 hours of continual testing and around 8 hours to write up the report / determine profile.

14. Full Diagnostic assessment - Jane
Underlying ability (verbal & non-verbal)
Processing speed
Working memory
Phonological processing
Reading & Comprehension
Spelling and prose writing
Looking for deficits in processing speed and working memory, by comparison to verbal comprehension and perceptual organization (refer to bar chart)

15. Full Diagnostic assessment - outcome
EP Compares:
data across all the psychometric tests & test behaviour
outcome of screening interview
students self report of difficulties
Triangulation of results. All 3 data collection methods show same pattern of dficits in the areas of dyslexia – i.e processing speed, working memory & phonological awareness , by comparison to verbal comprehension and perceptual organization (refer to bar chart) .

16. Full Diagnostic assessment - outcome
Diagnosis of dyslexia due deficits in:
Working memory
Speed of processing
Phonological awareness
meets definition of dyslexia (see handout)
Recommendation is 25% extra time in exams to compensate for slow processing speed (slow reading and writing) and poor working memory (need to re-read)
Triangulation of results. All 3 data collection methods show same pattern of dficits in the areas of dyslexia – i.e processing speed, working memory & phonological awareness , by comparison to verbal comprehension and perceptual organization (refer to bar chart) .

17. Diagnostic assessment process - timeframe
Student contact – screening interview appointment = 2 weeks
Screening interview appointment – EP appointment = 2 weeks
EP write up report = 2 weeks
Student feedback appointment at DRC for support arrangements = 2 weeks
Minimum of 8 weeks from initial contact to discussion of report and support arrangement
In addition – during feedback meeting student applies for DSA to fund support– 12 weeks process before funding for support is available.
It takes at leas a full term for a student to go through all the stages of being assessed for SpLD. This is not a quick process and students coming late in MT risk not meeting the deadlines for the BoE for exam access arrangements. In addition, once they have their diagnostic report students can apply for support funded by DSA (equipment an study skills support) – this process is determined by SFE and takes 12 weeks minimum. It is crucial that students come forward before they are in crisis

18. Diagnostic assessment process
Any questions?
Triangulation of results. All 3 data collection methods show same pattern of deficits in the areas of dyslexia – i.e processing speed, working memory & phonological awareness , by comparison to verbal comprehension and perceptual organization (refer to bar chart) .

19. Diagnostic assessment process
Useful contacts and links:
DRC website
Inclusive teaching DRC Online resources (via DRC website)
DRC workshops : Teaching students with Specific Learning Difficulties (via PPD)
Triangulation of results. All 3 data collection methods show same pattern of deficits in the areas of dyslexia – i.e processing speed, working memory & phonological awareness , by comparison to verbal comprehension and perceptual organization (refer to bar chart) .