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  • Bee Schlotz


(part of a series on Specific Learning Disability types)


This post will explore the basics of Dysgraphia, also known in some contexts as Writing Disability. I'll cover some basic descriptions of the condition, its roots and treatment, and an example of a (fictional but based in reality) child with Dysgraphia and how he was treated.


Definitions and Root Causes

The Diagnostic Statistical Manual Fifth edition, which is used by psychologists and other mental health professionals worldwide, defines these as the core criteria for Dysgraphia

  • “Difficulties with spelling” or “written expression” in the domains of grammar, punctuation, organization etc.

  • Being “substantially and quantifiably” below expectations based on age.

  • These difficulties may go undetected until the students abilities are overtaxed by new academic demands.

  • The difficulties aren’t better explained by other variables (eg, vision acuity, lack of language proficiency, inadequate teaching etc)

These symptoms may be related to a number of different underlying problems - possibly psychomotor coordination issues, possibly related to dyslexia (which in turn as described above often entails phonological awareness deficits), or in the case of students who struggle only with punctuation and organization, working memory and inhibitory skills. One confounding element is that any of these may cause the student to avoid writing, leading to other writing domain issues (eg, painful handwriting resulting in difficulty in spelling and organization).


Determining which of these (or which set of them) is an important first step. If a student’s primary difficult is psychomotor dysfunction then they need to be referred to an occupational therapist, along with academic interventions to help alleviate the surface symptoms if they’ve developed.


If a student struggles only minimally with handwriting but finds spelling difficult would probably benefit from focused direct instruction in spelling - practice with phonemic awareness as described in the section on dyslexia, and also spelling specific strategies like CCC (Cover, Copy, Compare). On the other hand, if organization and editing are the primary difficulties, as is often the case with late elementary and junior high students, the Self Regulated Strategy Development has been shown to be effective for learning disabled and neurotypical students.


What it looks like

A student with dysgraphia may have messy illegible handwriting, hold pencils or crayons very tightly to the point where it’s clearly painful, and/or may exhibit difficulties with other fine motor skills like using buttons or zippers. They may drop letters or endings for words, or over-rely on simple phonetic rules, or avoid writing because they’re worried about using misspelled words.

Tests of handwriting fluency can reveal dysgraphia, as can simple spelling tests. The TOWL4 is primarily used to assess higher order thematic writing skills, while basic motor skills such as the pegboard test may be used to check for psychomotor dysfunction.


Working with Amadi

Amadi is a 10 year old who struggles with spelling. He was referred to me by his teacher, who has concerns that his verbal abilities aren’t reflected in his writing. He is a gifted artist, skilled with pencils and crayons, which suggests to me his difficulties don’t stem from fine motor dysfunction. He is also fairly capable of copying words accurately if slowly, needing to look up every letter or two. But when asked to spell an unfamiliar word or phonetic nonsense word, his answers bear little resemblance to the correct answers (eg “derg” for “drag”).


My recommendation for this student is direct instruction addressing any phonological awareness deficits, as I would with a student with dyslexia. This will hopefully give him a better grasp of the orthographic rules underlying English spelling, as well as a better ability to decompose spoken words into phonemes. The other half of the instruction would use the CCC method to build his visual memory encoding.


I’d also recommend that they pursue dictated answers as an accommodation - if he is being assessed on something other than spelling, but the spelling is preventing him, the assessment isn’t doing its job. If he prefers typing answers, that should be an accommodation as well.

  • Bee Schlotz


(part of a series on Specific Learning Disability types)

Today we'll explore the basics of Dyscalculia, also known in some contexts as Math Learning Disability. I'll cover some basic descriptions of the condition, its roots and treatment, and give an example of a (fictional but based in reality) child with Dyscalculia and how he was treated.


Definitions and Root Causes

The Diagnostic Statistical Manual Fifth edition, which is used by psychologists and other mental health professionals worldwide, defines these as the core criteria for Dyscalculia

  • “Difficulties with number sense” or “mathematical reasoning “

  • Being “substantially and quantifiably” below expectations based on age.

  • These difficulties may go undetected until the students abilities are overtaxed by new academic demands.

  • The difficulties aren’t better explained by other variables (eg, vision acuity, lack of language proficiency, inadequate teaching etc)

The underlying core of this disorder seems to be working memory deficits, which results in impaired numerosity (number sense). Number sense is the intuitive grasp of the number line, and how it relates to things like place value, operations, fractions and so on. Generally, students move from a concrete understanding of the number line as represented in tallies, counting fingers and so on, to an abstract understanding of the number line which they can summon mentally. Students with MLD however generally lag behind on this transition, over relying on concrete representations of number.


The second subtype as described by the DSM has to do with applying math to situations correctly, as in word problems or real world contexts. These two subtypes are related but also seem to be distinct (as its quite common for a student to struggle with one but not the other), and caused by different cognitive issues - “mathematical reasoning” difficulties seem to be caused by underlying language difficulties.


What it looks like

Persistent low scoring on standardized math assessments and in-class assignments are how MLD is usually evaluated. Tests such as CogAT (cognitive ability test) can help identifying any underlying dysfunction, which helps direct interventions.


Working with Nguyet

Nguyet is 12, and has always struggled in math but was able to get by, but the introduction of prealgebra in junior high is rapidly falling behind. She tends to still surreptitiously count on her fingers when attempting mental math. She also has considerable anxiety around the subject, and frequently forgets math facts under pressure.


My instructional recommendations is using a tutoring program that gradually phases out physical manipulatives in its development of number sense. She needs extra assistance to make it from the concrete stage to the abstract, and that’s going to require a careful transition. The Making Math Real program is centered around how to slowly phase out the physical representations of the number, and although it’s a bit too rigid in places I think it might be a good fit here.


It’s also important that she develop some anxiety management strategies for dealing with the built up stress associated with the subject. There’s several good resources available along these lines, including the excellent “Anxiety Workbook for Teens” from Instant Help Books.

The main recommendation I’d make in terms of accommodation is for her to have access to a calculator on all or most math and science tests. In Junior High and High school, math tends to be focused much more on the higher order problem solving skills than on arithmetic (which is the primary difficulty in Nguyet's case).

  • Bee Schlotz

(part of a series on Specific Learning Disability types)

This post will explore the basics of Dyslexia, also known in some contexts as Reading Disability. I'll cover some basic descriptions of the condition, its roots and treatment, and an example of a (fictional but based in reality) child with Dyslexia and how she was treated.


Definitions and Root Causes

The Diagnostic Statistical Manual Fifth edition, which is used by psychologists and other mental health professionals worldwide, defines these as the core criteria for Dyslexia

  • “Inaccurate or slow word reading” and/or “difficulty understanding meaning of what is read” which persists more than 6 months.

  • Being “substantially and quantifiably” below expectations based on age.

  • These difficulties may go undetected until the students abilities are overtaxed by new academic demands.

  • The difficulties aren’t better explained by other variables (eg, vision acuity, lack of language proficiency, inadequate teaching etc)

The core of this disorder seems to be impaired metalinguistic awareness, which is to say the intuitive ability to analyze and decompose words and sentences. This impairment is often primarily phonological, meaning it relates to the distinguishing the individual sounds in a word (eg, the sounds /s/, /t/, /i/ and /p/ in the word “steep”), although it often entails deficits in morphological (relating to meaningful affixes of words), syntactic and semantic deficits as well. Often, if the primary difficulty is phonological, a child will attempt to compensate by relying more on the syntactic and semantic domains as a tool for word identification.


What it looks like

Some major signs of dyslexia include slow and stumbling reading, misidentifying words (especially replacing words with contextually appropriate but unrelated words), misspelling words with similar sounds (eg “dag” for “dog”).


In addition to formal tests like the Woodcock Reading Mastery Test, dyslexia can be informally evaluated by having the child read and/or spell a set of nonsense words. Because these words cannot be memorized in advance, they put extra pressure on the phonological component of reading - that is, the ability to sound out unfamiliar words. Nonsense words given in a syntactic context, where students are asked to conjugate or pluralize the nonsense word, (eg the classic test “This is a wug. Now there are two of them. There are two ____” from Jean Berko Gleeson) may be used to assess a student’s facility with morphological awareness.


Working with Layla

Layla is an 8 year old child (a fictional composite of many students I've worked with) from a well educated affluent family. She is the youngest of 3 and attends her local elementary. Her parents are concerned that she is lagging behind her peers, and where her siblings were at the same age. I was brought in to informally assess and create a plan for remediation.


Layla had a sunny friendly disposition, showing excellent determination in working through what was clearly difficult subject. I asked her to read some graded sample passages, about a paragraph long, and compared her fluency and error rate to the mean and median for kids her age. I also asked some comprehension questions, and checked her ability to spell and read pseudowords of various complexity (from “op” to “blump”). Her performance on these suggested to me she has some deficits in phonological awareness, not extreme but roughly in the 30th percentile for her age, and probably lower relative to her privileged peer group.


I recommended she receive 40-60 hours of direct instruction in learning sound letter correspondences, vowel rules, with some visual working memory exercises, influenced by methods the Lindamood-Bell LiPS program, in which possible auditory processing deficits are circumvented by using tactile feedback and oral motor skills.


One of the concerns with students who struggle with reading is that their difficulties in this domain will spread to others, as increasingly students read for instruction in math, science and social studies. To help mitigate this I would encourage the teacher to offer the accommodation that assessment and instruction in text should be read aloud for the student to ensure accessibility.