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Using Selective, Cross-Battery Assessment to Identify Children’s Psychological Processing Deficits Milton J. Dehn, Ed.D., NCSP Schoolhouse Educational Services Fall 2012 Notice of Copyright 2012 This PowerPoint presentation and accompanying materials are copyrighted by Schoolhouse Educational Services, LLC and Milton J. Dehn. They are not to be reprinted, copied, or electronically disseminated without written permission. To obtain permission, email [email protected] Workshop Information Sources • References in handouts • Dehn, M. J. (2006). Essentials of Processing Assessment (revision in 2013) • Dehn, M. J. (2012). Children’s Psychological Processes Scale (CPPS) • Presenter email [email protected] • www.psychprocesses.com Workshop Topics 1. 2. 3. 4. 5. 6. 7. Overview of psychological processes Processes to assess Processes and academic skills Cross-battery testing Analyzing cross-battery results Using processing rating scales Case studies Psy Processing and LD • Federal Definition: “a disorder in one or more of the basic psychological processes” • Disorders other than LD also have processing disorders/problems Author’s Personal Goals 1. Help LD students realize their potential 2. Earlier identification of LD 3. Assessment that benefits the learner by increasing understanding of “why” 4. Develop measurement tools that solve a problem & have high technical standards 5. Add to the research on psychological processing deficits What are psychological processes? 1. Brain processes, operations, functions 2. Any time mental contents are operated on 3. When information is perceived, transformed, manipulated, stored, retrieved, expressed 4. Whenever we think, reason, problem-solve 5. Can’t learn and perform without processing 6. Learning depends on these processes 7. Doesn’t include knowledge or academic skills Human Processing Limitations 1. Human limitations Problems with Past Processing Assessment 1. 2. 3. 4. 5. 6. Not enough known about processing Not sure how to test processing Assessment too informal Did not include higher level processes Memory seldom assessed Controversies over the value of processing assessment 7. Some ineffective interventions Improvements in Processing Assessment and Intervention 1. More and better processing tests 2. Neuroscience and neuropsychological evidence on brain and learning 3. Neuropsychological influence on assessment (what underlies the learning problems) 4. Research on processing, memory, academics 5. More assessment of memory 6. Updated & new research on interventions 7. New interventions What Have We Learned 1. More about the processes needed for academic learning 2. The specific areas of the brain involved in childhood disorders 3. Childhood disorders, including SLD’s have a neurobiological basis 4. Interventions should be evidence-based 5. The discrepancy model did not work well for LD identification Why Processing Assessment is a Good Idea 1. Benefits the learner, understanding 2. Processing deficits underlie SLD 3. Identifying a processing deficit differentiates between SLD & slow learning better than IQ testing 4. Interventions for processing deficits 5. Identifying processing deficits provides direction for academic interventions The Need for More Processing Assessment 1. Part of a neuropsychological approach 2. Not just for LD; e.g. executive for ADHD 3. In depth, brain-related assessment needed because of more children with medical conditions; e.g. head trauma 4. Private practitioners often don’t connect with school environment needs and criteria Processing and RTI 1. Processing model consistent with problemsolving and early intervention 2. RTI purists are not current; too behavioral 3. Evidence-based processing interventions 4. Different processing causes of disabilities 5. Why do “blind” general academic interventions 6. Processing & acad. interventions compatible 7. Which academic interventions succeed? 1. Those that address processing problems “Resistance” to Intervention • Successful achievement depends on adequate psychological processes • Processing deficits create roadblocks to learning • A processing deficit can cause an academic intervention to fail – When severe – When not addressed Characteristics of Psychological Processes to Assess 1. 2. 3. 4. 5. Brain-based Interrelated Necessary for academic learning Broad and narrow processes Related behaviors observable in classroom Brain Lobes and Processes • Frontal Lobes: Attention, Executive Functions, Working Memory • Temporal Lobes: Long-Term Memory, Auditory Processing, Short-Term Memory • Parietal Lobes: Fine motor, Working Memory, Auditory, Phonological, • Occipital Lobes: Visual-spatial processing Dehn’s Recommended Processes for SLD Assessment 1. Attention 2. Auditory Processing 3. Executive Functions 4. Fine Motor 5. Fluid Reasoning 6. Long-Term Recall 7. Oral Language 8. Phonological Processing 9. Processing Speed 10. Visual-Spatial Processing 11. Working Memory Attention 1. Necessary for learning and memory 2. Attention deficits part of LD; not necessarily ADHD 3. Types: Selective, focused, divided, sustained 4. The problem is attentional control & lack of inhibition 5. Related to Executive Functions and Working Memory Auditory Processing 1. Ability to perceive, analyze, synthesize, and discriminate auditory stimuli, mainly speech 2. Perceiving and comprehending instruction; being able to understand words with background noise Executive Functions 1. Management of cognitive functions and psychological processes 2. Effectiveness depends on self-monitoring, selfregulation, and metacognition 3. Has a longer course of development 4. More to do with classroom performance than learning of academic skills Fine Motor 1. Hits developmental plateau by age 7 2. Has weaker relations with cognitive processes in general but has strong relations with academics 3. Often pairs up with visual-spatial processing Fluid Reasoning 1. Deductive, inductive reasoning, especially with novel materials 2. Has a longer course of development 3. More important for applied academics Long-Term Recall 1. Close connection with other processes and with academic learning in general 2. Includes encoding, consolidation, storage, and retrieval 3. Rapid automatic naming is part of Oral Language 1. Not the content (vocabulary) or receptive language but the oral expression processes Phonological Processing 1. Processing of phonemes, e.g. blending 2. Phonemic awareness is part of Processing Speed 1. How quickly information flows through the processing system; a matter of efficiency 2. Too slow: info. lost, process not completed Visual-Spatial Processing 1. The ability to perceive, analyze, synthesize, manipulate and think with visual patterns 2. A strength in most LD cases 3. Weak relations with all academics; more of a “threshold” process Working Memory 1. Processing while retaining information 2. Includes short-term memory 3. Both verbal and visual Processes and Academic Learning 1. Psychological processes are like “aptitudes” 2. Relations established through research 1. Flanagan et al., & McGrew’s review 2. Swanson, Geary, and others 3. The influence of processes varies by age 4. Look for academic area and related psychological processes to both be low 5. See Table Research: SLD by Processing Subtypes 1. Visual-Spatial Deficits: Math calculation and math problem solving 2. Processing Speed Deficits: Reading comprehension, written expression 3. Working Memory Deficit: Math calculation, Written expression 4. Attention: Written expression Source: Hain, Hale, Kendorski Development of Processes • Early gradual development followed by long-term plateau: auditory, visual, longterm memory, fine motor • Rapid early development followed by gradual decline after age 25: processing speed, short-term memory • Gradual development into teens/20s: attention, executive, fluid reasoning, WM • Basic functions develop earlier; higher level, such as executive later Highest Influence of Processes on Academics by Grade • Early elementary: Phonological, visual, auditory, rapid automatic naming, STM, sequencing, fine motor control • Late elementary and beyond: Executive, working memory, long-term memory • All grades: Processing speed, attention, oral expression Processing Assessment Challenges 1. 2. 3. 4. 5. 6. 7. Connecting to academic concerns Interrelated processes Informal methods lack validity Not found in one convenient battery Doing it efficiently Having enough expertise Linking with interventions Processing Assessment 1. 2. 3. 4. 5. 6. 7. 8. Should be multimethod/multisource Multi-settings Formal and informal Should include standardized testing Should be hypothesis driven (suspected) Based on referral concerns Selective, cross-battery testing Integrate data during interpretation Selective, Cross-Battery Testing 1. Assess areas based on concerns, not on what a test has to offer 2. Mix tests/batteries to cover all the areas 1. Limit to 2 or 3 batteries 2. Should be normed about the same time 3. Avoid redundancies 4. Ideally, 2 subtests per process 5. Analyze results together by computing a cross-battery mean or using IQ Dehn’s Approach to Cross Battery 1. Not limited to CHC factors in Flanagan and Ortiz method 2. Includes processing factors that are important for learning of academic skills 3. Analyze scores at the factor (twosubtest) level whenever possible Hypothesis Testing Approach 1. Collect preliminary data 1. Records review, observation, interview 2. Identify referral concerns 3. Generate processing hypotheses (suspected processing problems) 4. Select assessment methods 1. Cover all hypotheses 2. Avoid redundancies Selective Testing 1. Apply a cross-battery approach 2. See selective testing table for cog. & ach. Link 3. Use a hand computation analysis sheet or the Psychological Processing Analyzer Completing the Processing Assessment Planner 1. Enter academic learning referral concerns 2. Look at Table 1: Processes and learning 3. Enter hypothesized, suspected processes 4. Select assessment method 5. Look at selective testing tables 6. Select battery 7. Select specific subtest or factor Planner Completed Example Cross-Battery Analysis of Scores 1. See Processing Analysis Worksheet 2. Get factor scores from test manual when possible 3. Exclude non-processing factors and subtests 4. Compute clinical factor scores by averaging 1. First convert scaled scores to 100/15 metric 5. 6. 7. 8. Compute processing mean or use IQ Calculate difference scores Determine weaknesses and deficits Do pairwise comparisons Completed Example Examples of Logical Processing Pairs • • • • • • • • • Should be opposites or closely related Visual vs auditory STM vs LTR Phonological vs STM Attention vs Executive Auditory vs verbal expression Verbal expression vs fine motor control WM vs STM and WM vs LTR Not related ex.: auditory and fine motor Identifying Strengths and Weaknesses 1. These are intra-individual strengths and weaknesses 1. At least a 12 point standard score difference from the mean of processing scores 2. As opposed to normative weaknesses 1. Below average score (below 90) 3. For diagnosis, should be both an intraindividual weakness and a normative weakness 4. When it’s both, Dehn refers to as “deficit” Support for Strengths and Weaknesses 1. Informal data supports test scores and results of score analysis 2. Corroboration especially needed when scores differences are less than one standard deviation (12-14 points) 3. Integrate data when writing report 4. They match with specific academic areas they are highly related to Evidence for a Processing Disorder and SLD Diagnosis 1. It’s not specific to one environment 2. A normative weakness (below average score) 3. Intra-individual: score is significantly weaker than predicted from discrepancy analysis 4. Best if it’s an intra-individual weakness and a normative weakness (this is a deficit) 5. It’s impairing academic learning 6. The low psychological processes and low academics have research-based links 7. The linked process and academic skills both have low scores (consistency approach) 8. Non-LD also have strengths and weaknesses Consistency Approach • With processing, use a consistency approach, not a discrepancy approach – Low process + low academic skill = SLD – NOT high process + low academic skill Case Study: “Jacob” 1. 2. 3. 4. 5. 6. 7. 8. Age 13; 7th grade Foster care; special ed placement 3 months premature; failure to thrive Early elementary IQ of 70; recent IQ of 95 ADHD diagnosis; poor organization Social skills problems Difficulty completing homework Moderately high test anxiety Case Study Continued 1. 2. 3. 4. 5. 6. 7. Likes to read Struggles with Math and Written Lang. Reading Composite – 106 Math Composite – 88 Wr. Lang. Composite – 73 Oral Lang Composite - 87 List your processing hypotheses to account for low achievement and background factors Psychological Processing Analyzer 1. Available at www.psychprocesses.com 2. To identify pattern of strengths and weaknesses 3. Conducts cross-battery analysis using composites and/or subtest scores 4. 11 psychological processes 5. From 22 different scales: cognitive, achieve., rating, and processing scales (list) Psychological Processing Analyzer 1. Composite and subtests are limited to those that are fairly direct measures 2. Some are re-classified based on the primary demands of the task; example 3. Difference formulas based on reliability coefficients of composites/subtests 4. Regression toward the mean 5. .01 or .05 level of significance Psychological Processing Analyzer 1. All scores converted to standard scores 2. Non-unitary process scores are flagged 3. Predicted score for each processes based on mean of other 10 4. Differences greater than critical values are intra-individual weaknesses 5. Deficits are both types of weaknesses 6. Pairwise comparisons are optional PPA Case Study Struggling 2nd year college student Significant problems with math Intensive tutoring in past Indications of memory problems Family history of LD Administered WJ III COG., WMS-IV, and parts of WAIS-IV 7. See results 1. 2. 3. 4. 5. 6. Measures of Specific Processes • • • • • • Rating Scales Achievement Tests Language Memory Phonological See List The BRIEF • Behavior Rating Inventory of Executive Function • Parent, Teacher, and Student Forms • Ages 5-18 • 86 items • Has a global executive composite score • Two Indexes: Behavioral Regulation and Metacognition Rating Scales: Children’s Psychological Processes Scale (CPPS) 1. 2. 3. 4. 5. 6. 7. Standardized teacher rating scale Ages 5-0-0 to 12-11-30 121 items across 11 subscales Internet, web-based test Administration time of 15 minutes Online scoring and report Author: Milton Dehn; published by Schoolhouse Educational Services, 2012 8. Measurement Consultant: Kevin McGrew Uses of the CPPS 1. LD Evaluations 1. 2. 3. 4. Identify psych processing deficits Pattern of strengths and weaknesses Planning further assessment Planning interventions 2. Screening 1. Identifies need for intervention 2. Predicts academic skills development 3. Useful in planning comprehensive assessment 3. Measure progress during interventions 1. Through the use of change-sensitive W-scores CPPS Items • Grouped by subscale • In developmental (ability) order from lowest item to highest item • Link • Example of scoring in developmental sequence Link CPPS Standardization 1. 2. 3. 4. 5. 6. 7. 1,121 students rated by 278 teachers 128 communities in 30 states All data collected online Demographics match U.S. Census well Scores were weighted Included children with disabilities Demographics details Link W-Scores 1. Used in item analysis, development of scoring system, and in reports 2. Mean of 500 at age 10; SD of roughly 20 3. Converts ordinal rankings to equal interv. 4. More precise measurement 1. Gradient smaller steps: 4-5 W = 1-2 T-score 2. More sensitive to changes, progress 5. Use when re-evaluating student How The Online CPPS Works 1. A psychologist’s side and a teacher’s side 2. Psychologist fills in teacher information and email sent 3. Teacher completes ratings 4. Psych generates report 5. See demonstration video CPPS Report 1. 2. 3. 4. Brief narrative, graph, and a table of scores Change-sensitive W-scores T-scores; percentiles; confidence intervals Intra-individual strengths and weakness discrepancy table 5. T-score to standard score converter 6. Can be re-run with different options (without a charge) Example Discrepancy Analysis 1. Use discrepancy table to determine pattern of strengths and weaknesses 1. 2. 3. 4. Predicted score based on mean of other 10 Regression toward the mean included +/- 1.00 to 2.00 SD of SEE discrep options Strengths and Weakness labeling is opposite of discrepancy, e.g. “-” value = a strength 5. Link Conversion Table 1. Optional 2. Purpose: To see how consistent CPPS scores are with achievement and cognitive scores 3. T-score x 1.5 + 25 and then reverse distance from mean 4. Example: T-score of 60 x 1.5 = 90 + 25 = 115 5. Then subtract 15 from 100 = 85 Link Diagnostic Utility for LD 1. 37 LD subjects with broad demographics 2. Compared to matched controls, LD subjects had significantly higher means on all subscales Link 3. The CPPS has high classification accuracy in regards to LD 1. Using CPPS GPA cutoff of 60 has 92% classification accuracy across 74 subjects Diagnosing LD with the CPPS 1. Use a T-score of 60 or above on the GPA or a more conservative cutoff of 65 2. Individual subscales of 65 or higher 3. Look for pattern of strengths and weaknesses (discrepancy table) 1. Weaknesses should also be above average scores 2. Weaknesses should link to evidence-based achievement relations Link Using CPPS Results to Guide Standardized Testing 1. 2. 3. 4. The WJ III COG is a good match Other scales, such as memory, BRIEF Use selective testing table Sample all processing areas but especially weak and borderline areas 5. CPPS processes with scores above 60 should be sampled with at least 2 subtests Using the CPPS to Measure Progress 1. 2. 3. 4. Use W-Scores Have a mean of 500 at age 10 Standard deviations vary (about 20) 4-5 W-score points for every 1-2 T-score points 5. A change of 20 points can be considered statistically significant Using the CPPS to Plan an Intervention 1. Select processes with scores above 60 (weaknesses) 2. Prioritize if too many 3. Look for strengths (scores below 40) to counterbalance weakness Correlations with Achievement 1. High correlations with WJ III Achievement Test scores Link 1. The broader the achievement score, the higher the correlations 2. Correlation of .66 between teacher’s overall ranking of academic skills and CPPS GPA 3. Parent education level and CPPS GPA is .33 Factor and Cluster Analysis 1. A general factor; all subtests load on 1. General Processing Ability (GPA) may reflect processing efficiency or automaticity Link 2. Second factor is Attention, EF, sometimes WM: Self-Regulatory Processes 3. Third factor is Fine Motor and Visual-Spatial: Visual-Motor processes Link 4. Results fairly consistent across age groups CPPS General Processing Ability (GPA) 1. Based on average of all process scores 2. Emerges from factor analysis; similar to concept of general intelligence 3. Processes function in an inter-related fashion 4. Most processes contribute to any given behavior, task 5. On CPPS defined as “the underlying efficiency of automaticity of processing” Case I Background 1. 5th grade, 12 year old male 2. History of struggling with Math & Wr Lang 3. Received tutoring and extra help at school 4. Not placed for LD after eval. 2 years prior 5. Average IQ 6. Doesn’t meet ADHD diagnostic criteria 7. Seems immature Case I CPPS Scores Attention 62 Auditory Processing 51 Executive Functions 55 Fine Motor 63 Fluid Reasoning 64 Long-Term Recall 61 Oral Language 61 Phonological Processing 53 Processing Speed 58 Visual-Spatial Processing 48 Working Memory 63 General Processing Ability 60 Case I WJ Cog Scores Comp-Knowledge LT Retrieval Vis-Spatial Auditory Proc Fluid Reasoning Process Speed ST Memory Phonemic Aware Working Memory Broad Attention Cognitive Fluency 97 *a close match with CPPS 86* 93* 97* 103 82 90 103* 87* 90 85 Case I WJ III ACH Broad Reading Broad Math Math Calc Skills Broad Wr Lang Writ Exp 91 89 90 86 85 See CPPS Discrepancy Table Case I Conclusions 1. From a processing perspective, could qualify for LD 2. Does not because IQ-Ach discrepancy not severe enough 3. Nevertheless, struggles because of processing problems 4. Received working memory training Conclusions About Processing Assessment • It can be done well but there are challenges • Professional judgment is necessary • Selective, cross-battery testing necessary • Test the processes associated with the academic deficiency • Use the consistency approach • Explain the link