Training Preprofessional Speech-Language Pathologists
to Identify Dysgraphia and Dyslexia
Behavioral Indicators in Children’s Writing
2023 ASHA Conference
Boston, MA
Session #3550V
30 minutes
Authors
Abbie Olszewski
PhD, CCC-SLP
Mercedes Baggett
M.S. CCC-SLP
Lindsay Diamond
PhD
Financial Disclosures
●
Abbie Olszewski, PhD, CCC-SLP and Lindsay Diamond, PhD are employed by University
of Nevada, Reno.
●
The contents of this article were developed and researched under a grant from the U.S.
Department of Education, #H325K190034. However, this content does not necessarily
represent the policy of the U.S. Department of Education, and you should not assume
endorsement by the Federal Government.
Nonfinancial Disclosures
●
Baggett, M., Diamond, L., & Olszewski, A. (2023). Dysgraphia and dyslexia indicators:
Analyzing children’s writing, Intervention in School and Clinic, 1-12.
https://doi.org/10.1177/10534512231189449
Agenda
1. Learner Outcomes
2. Introduction
3. Methods
4. Results/Discussion
5. Limitations
6. Clinical Implications
1. Learner Outcomes
Learner Outcomes
1. Define “dysgraphia” and “dyslexia” and discuss how they are
associated with educational eligibility categories.
2. Identify behavioral characteristics associated with dysgraphia,
dysgraphia and dyslexia, and dyslexia.
3.
Identify behavioral characteristics that would warrant a
consultation or referral to a speech-language pathologist and/or
occupational therapist.
2. Introduction
Help!
The Challenge
● Critical members of interprofessional
team
● Literacy is in scope of practice
● 39% no literacy training in graduate
school
● 56% of SLPs practice in an educational
setting
(ASHA 2001; IDEIA, 2004; Spracher, 2000)
Why is this important?
● Every Student Succeeds Act (2015)
● Disadvantage after secondary
education
● 33% receive special education
services for SLD
(National Center for Education Statistics, 2022; NGA Center and CCSSO, 2010)
A Solution (Study Purpose)
● Self-paced video training
● Identify dysgraphia and dyslexia
behavioral indicators
● Confidence, knowledge, and skills
● 317 master’s degree programs in
speech-language pathology
(Council on Academic Accreditation, 1997-2023)
Research Question 1
Does a self-paced video training lead to improved
confidence, knowledge, and skills in identifying
behavioral indicators in students’ writing samples
of Specific Learning Disabilities in reading in
writing in comparison to a control group?
(Between Groups)
Research Question 2
Does a self-paced video training lead to
improved confidence, knowledge, and skills in
identifying behavioral indicators in students’
writing samples of Specific Learning Disabilities in
reading in writing within the experimental and
control groups?
(Within Groups)
3. Methods
Participants
Inclusion criteria:
1.
Currently a graduate student in speech pathology /
audiology or special education program
2.
Self-reported grade point average of 3.0 out of 4.0 or
higher.
Participants:
●
N = 10 (Group E = 5, Group C = 5), speech-language
pathology graduate students
●
3.2 GPA or higher
●
21 to 37 years old
●
All female
Procedures
Experimental Group
(Group E)
Control Group
(Group C)
Week 1
Recruitment
Week 2
Recruitment
random assignment to groups
Week 3
Pre-Survey
Pre-Survey
Week 4
Training (Group E)
Post-Survey 1
No Training (Group C)
Post-Survey 1
Week 5
No Training (Group E)
Post-Survey 2
Training (Group C)
Post-Survey 2
Training Topics
1. Specific learning disabilities (SLD)
2. Overview of dyslexia and dysgraphia
3. Behavioral indicators of dyslexia and dysgraphia
4. Practice and roles
Topic 1. What are Specific Learning Disabilities (SLDs)?
IDEA defines specific learning disability as “a disorder in one or more of the
basic psychological processes involved in understanding or in using
language, spoken or written, which disorder may manifest itself in the
imperfect ability to listen, think, speak, read, write, spell, or do mathematical
calculations (IDEA Section 1401 (30)).
・・・
A collection of neurodevelopmental disorders that impact an individual’s ability to
learn and use skills specific to academic success (e.g., reading, writing, and
mathematics) including “such conditions as perceptual disabilities, dyslexia,
dysgraphia, dyscalculia, dyspraxia, and developmental aphasia that continue to
exist in the presence of/or following tried evidence based interventions (APA, 2013;
Blanchet & Assaiante, 2022)
Topic 2: Defining Dyslexia
● Specific learning disability in reading, specific reading
impairment, and language learning disability
● Language-based disorder
● Characterized by difficulty with the phonological
aspects of language
● Difficulties with accurate and/or fluent word
recognition and by poor word spelling and decoding
abilities
● Secondary consequences in reading comprehension
(Nelson, 2010; Colette, 1979)
Simple View of Reading
(Gough & Tunmer, 1986)
Language
Comprehension
(Understanding
Spoken Language)
Decoding and Word
Recognition
(Sound to Symbol and
Automaticity of
Remembering Common
Words)
Reading
Comprehension
(Understanding
Written Language)
Topic 2: Defining Dysgraphia
●
Specific writing impairment
●
Impaired ability to produce legible and automatic letter
writing”
●
“Dysgraphia is the condition of impaired letter writing
by hand, that is, disabled handwriting. Impaired
handwriting can interfere with learning to spell words in
writing and speed of writing text.
●
Children with dysgraphia may have only impaired
handwriting, only impaired spelling (without reading
problems), or both impaired handwriting and impaired
spelling” (Berninger & Wolf, 2020; IDA, 2020).
Simple View of Writing
(Herbert et al., 2018)
Topic 2: Challenges of Identifying Dyslexia
and Dysgraphia
●
Students’ learning impairments are defined “based on the highest level of language that is impaired”
(Berninger et al., 2015).
●
Students may or may not demonstrate difficulties in multiple areas of language (e.g., subword, word,
and syntax).
●
The acquisition of skills at higher levels of language are often impacted due to weaknesses in a
student’s main area of deficit.
●
However, “once the primary impairment is remediated, the problems at the higher level of language
resolve” (Berninger et al., 2015).
●
Supporting the need for quicker identification of and direct intervention for students with SLDs.
(Berninger et al., 2015)
Cascading Levels of Language Framework
(Berninger et al., 2015)
Syntax
●
Children with oral and written language deficits (OWLD)
present with difficulties at the syntax level e.g. “The cat is
sleeping”.
Word
●
Children with dyslexia present with reading and writing
difficulties at the word level e.g., “cat”
Subword
●
Children with dysgraphia present with difficulties in writing at
the subword level e.g., c a t
(Berninger et al., 2015)
Topic 2: Dual Route Model of Reading and Writing
Dual Route Model
of Reading and
Writing
(Dohla & Heim, 2016; Winkes, 2014)
Takeaways:
●
Subword errors often are associated with dysgraphia.
●
Word level errors are often associated with dyslexia.
●
Syntax level errors are often associated with DLD or
Oral and Written Language Learning Disorder (OWL LD).
“SLDs have writing
disabilities but at
different levels of
language”
(Berninger et al., 2015)
The cognitive systems required for reading and writing overlap and
can impact each other depending on their need of a student’s
working memory.
Topic 3: Behavioral Indicators
Writing Impairment (dysgraphia)
I-1. Atypical Writing’s Relation to the Vertical Axis
I-2. Margins/Space Planning
I-3. Inversions
I-4. Transpositions
I-5. Inconsistent Sizing of Letters
Seen in Both
I-6. Reversals
I-7. Spelling Errors
I-8. Letter Crowding/ Spacing
I-9. Poor Legibility
I-10. Inconsistent or Lack of Grammatical Conventions
I-11. Abandoned words
Reading Impairment (dyslexia)
I-12. Lack of diverse vocabulary
I-13. Poor idea development and/or lack of organization
Topic 4: Practice and Roles
Early Childhood Education Teachers are
often the first to identify concerns and are the
first point of contact for parents.
Speech Language Pathologists have the
training to observe the linguistic and social
implications of SLDs.
Occupational Therapists have training to
observe fine motor, visual spatial, proprioceptive,
and kinesthetic aspects of writing.
Next Steps: Referral or Continue Monitoring?
Results & Discussion
Confidence
(Between Groups)
Confidence
(Within Groups)
Confidence
● Confirmed hypotheses:
○ positive impact on
confidence between groups
○ positive impact on
confidence within groups
● First study
“the way the information was delivered
helped me learn new and unfamiliar
concepts while also keeping more familiar
concepts like dyslexia separate. The
different pictures that shared whether the
topic of discussion on a current slide was
related to SLDs in writing or reading were
both very helpful when I was taking notes”.
- Study Participant
Knowledge of SLDs and Roles/Responsibilities
Group E
(n = 4)
Pre-Survey
Average
Correct
PS1
Average
Correct
PS2
Average
Correct
Average Gain
Within Group
After intervention
68.5%
72%
74.5%
+3.5%
Average Difference
Between Groups
at PS1
10%
Group C
(n = 4)
87%
82%
84%
+2%
Knowledge of SLDs and Roles/Responsibilities
Group E
(n = 4)
Pre-Survey
Average
Correct
PS1
Average
Correct
PS2
Average
Correct
Average Gain
Within Group
After intervention
68.5%
72%
74.5%
+3.5%
Average Difference
Between Groups
at PS1
10%
Group C
(n = 4)
87%
82%
84%
+2%
Knowledge
● Confirmed hypotheses:
○ positive impact on
knowledge between groups
○ positive impact on
knowledge within groups
“after taking the PS1 I was not really sure if I
was going to ever be able to answer some of
these questions correctly, I was so eager to
have my chance to take PS2 because I knew I
would finally learn about some of these
concepts that I had no clue existed. After the
training it was so much easier to do the
checklist and referral because I knew that I
knew the information and felt more confident
in my answers”.
- Study Participant
Skills: Identification of Behavioral Indicators and Referral Accuracy
Area 1
Identify Behavioral
Indicators
Group E
Group C
Area 2
Need for Referral
Group E
Group C
Pre-Survey
Average
Correct
PS1
Average
Correct
PS2
Average
Correct
Average Gain
Within Group
After intervention
Average Difference
Between Group
at PS1
42%
57.25%
74.25%
59.25%
78.5%
69%
+ 32.25%
+ 9.75%
15%
75%
75%
0%
50%
100%
75%
- 75%
+ 25%
50%
Skills: Identification of Behavioral Indicators and Referral Accuracy
Area 1
Identify Behavioral
Indicators
Group E
Group C
Area 2
Need for Referral
Group E
Group C
Pre-Survey
Average
Correct
PS1
Average
Correct
PS2
Average
Correct
Average Gain
Within Group
After intervention
Average Difference
Between Group
at PS1
42%
57.25%
74.25%
59.25%
78.5%
69%
+ 32.25%
+ 9.75%
15%
75%
75%
0%
50%
100%
75%
- 75%
+ 25%
50%
Skills
● Partially supported hypotheses:
○ positive impact on identifying
behavioral indicators between
groups
○ Negative impact on referrals
between groups
○ Positive impact for both skills
within groups
“I cannot believe I did not know the names
of many of these indicators or in fact, had
never heard of them before. I wish that
when learning writing sample analysis my
teacher would have reviewed these so that
I would could have been aware, I had no
clue. At least I do know now though”.
-
Study Participant
5. Limitations
Limitations
● Number of participants
● Diversification in the program
of study of participants
● Special education
● Conciseness of terminology
6. Clinical Implications
Clinical Implications
● Need for preprofessional
training
● Self-paced video training is
promising
● Improved referrals
● Better student outcomes
Thank you!
2023 ASHA Conference
Boston, MA
Session #3550V
30 minutes
References
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