A Transdisciplinary Model for Assessment
and Treatment of Learning Difficulties
in Children and Adults
Tim Conway, Ph.D.
The Morris Center, Inc.
www.TheMorrisCenter.com
Transdisciplinary
• two or more disciplines pool their
approaches/knowledge and modify them, so that
by working together they are better able to
improve/treat the “problem” or “weak” skills.
Transdisciplinary Assessment & Treatment
Program for Learning Disabilities
Overview of Services
• Intake/Screening
Appointment
• Phase I Assessment
• Phase II Assessment
• Treatment
• Post-treatment Assessment
• Follow-up/Generalization
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Learning Disabilities - Reading
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Dys = difficulty & Lexia = words
Poor skills in Reading
Neurological in origin
Lifelong, but environment may alter course
Core deficit in Phonological Component of
Language
• Accompanying Challenges (~50%)
– ADHD
– Sensorimotor
– Behavior problems
Transdisciplinary Team
• Disciplines on the team
– Pediatrician/Psychiatrist
– Nursing/Nurse Practitioner
– Psychology/Neuropsychology
– Occupational Therapy
– Speech-Language Pathology
– Teacher/Special Education
Transdisciplinary Assessment
• Intake/Screening Appointment with Director
– Collection of records
– Identify presenting concern(s)
– Provide scope and sequence of assessment and
treatment program, timeline of program,
associated costs,…
– Provide research/educational data, identify
additional community resources, etc …
– Determine fit for The Morris Center’s services
and client’s needs
1960
Transdisciplinary Team
Assessment
Two Phase Assessment
Phase I: Broad Neurodevelopmental Evaluation
& Medical History
Phase II: Assessment of Specific Abilities to
Identify an Individual Profile of Strengths &
Weaknesses (for diagnostic and treatment
planning purposes)
Transdisciplinary Team
Assessment
• Phase I Evaluation (broad screening)
– Neurodevelopmental evaluation
• Medical and Developmental History & Exam
• Screening of all brain systems including
neuromotor, perception, learning, attention,
speech, language, memory, motor planning and
cognition.
• Nutrition, sleep, behavior, allergies, medical…
– Psychological evaluation
• Diagnostic interview – psychosocial, educational,
behavior, & family history.
Transdisciplinary Team
Assessment
• Phase I Assessment Team members:
– Nurse Practitioner or DevelopmentalBehavioral Pediatrician
– Clinical Psychologist or Pediatric Psychiatrist
– Director of The Morris Center
Transdisciplinary Team
Assessment
• Phase II – in-depth assessment to identify an
individual’s specific areas of strength and
weakness that may contribute to presenting
concerns or difficulties:
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Attention/Intention
Intelligence/Cognition
Oral Language
Memory
Sensorimotor
Written Language
Mathematics
Behavioral Observations
Transdisciplinary Team
Assessment
• Phase II Team Members
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Clinical Psychology
Neuropsychology
Occupational Therapy
Speech Language Pathology
Educational Specialist
Nursing
Psychometrist
Transdisciplinary Treatment
Program
• Key treatment features are based on
neuroscience and behavioral treatment research
findings
– Intensity (# of hours per day)
– Frequency (# of days per week)
– Specificity (clarity of treatment program)
• Ongoing data collection of program effects for
program self-evaluation
• Selective post-treatment assessment with
standardized tests to document treatment gains
Transdisciplinary Treatment Program
Treatment targets within an Transdisciplinary
model:
• Speech-Language Therapy
– Targets improving foundational language skills that may cause the
learning difficulty, e.g. phonological processing/decoding
• Occupational Therapy
– Targets sensory and motor skills that may contribute to learning
difficulties, e.g. sensory defensiveness, visual
processing/perception, etc.
• Psychiatric/Medical
– Medication and behavioral management of attention, mood or
behavior disorders.
• Psychological Treatment
– Client
• e.g. developing adaptive coping skills for academic and life stressors
– Parent
• e.g. better behavior management, conflict resolution training, etc…
– Client & Parent/Spouse (separately or combined)
• Developing adaptive family or marital functioning, relative to learning
difficulties.
Treatment - Case Study
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High school student
History of dyslexia
Years of school-based academic intervention
Years of reading tutoring
– commercial centers, by private 1:1 tutors…
– a family member was an ESE Reading Specialist
• A first-team athlete
• Weak skills in:
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reading (>5 years below grade), writing & spelling
comprehension
auditory and visual memory
visual-spatial
attention
Treatment - Case study
• Transdisciplinary Phase I & II assessments
identified weaknesses in:
– Language
• poor phonological processing, reading, spelling and
comprehension
– Occupational Therapy
• sensory integration deficits including poor praxis, vestibular,
visual vigilance, visual tracking, and visual processing
– Medical
• poor attention, as exhibited by difficulty maintaining attention
to relevant visual and auditory stimuli
Transdisciplinary Treatment
Program
• Individualized, Transdisciplinary treatment
– Speech-Language Therapy
– Occupational Therapy
– Clinical Psychology/Counseling
• Intensive, Frequent and Explicit Treatment
– 22-25 hours of language treatment per week
• 5 days/week for 4-5 hours/day
– 1 hour of counseling per week
– 1 hour of parent education per week
– 5 hours of occupational therapy per week
• 12 weeks of 1:1 Transdisciplinary treatment
– (duration of treatment is client dependent)
Documented Treatment Results
• Selective re-administration of pre-treatment
standardized, nationally normed-tests for
measurement of post-treatment gains.
• Graphical representation shows pre-treatment
scores as blue stars and post-treatment
scores as green stars
• Green arrows indicating areas of significant gain
or improvement.
pre-treatment skills
post-treatment skills
Transdisciplinary Assessment and
Treatment Goals
• Identify and then improve weak skills to develop new
strengths in:
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Language
Sensorimotor
Cognition/attention
Behavior
• Develop independent functioning in language, sensorymotor, behavior & achievement, relative to an
individual’s true potential.
• Provide essential “tools” for success in academic,
occupational and interpersonal domains of life.
Thank You
www.TheMorrisCenter.com