Assessing Learning Disabilities in Adults

ORBIDA ConferenceFebruary 22, 2008

Ken KoskoEducation Evaluation Center

The Teaching Research InstituteWestern Oregon University

SLDRehabilitation Services Administration (RSA)1985

Definition:A specific learning disability is a disorder in one or more of the central nervous system processes involved in perceiving, understanding, and/or using concepts through verbal (spoken or written) language or nonverbal means. This disorder manifests itself with a deficit in one or more of the following areas: attention, reasoning, processing, memory, communication, reading, writing, spelling, calculation, coordination, social competence, and emotional maturity. (Rehabilitation Services Administration. (1985, January 21). Program policy directive. Washington, DC: U.S. Office of Special Education and Rehabilitation Services.)

SLDDEFINITION-RSA

Central Nervous System Processes

1. Perceiving

1. Understanding

Spoken or Written Language

Manifestations:

Attention Reasoning Memory Communicating Academics (reading, writing, math) Coordination Social Competence Emotional Maturity

Major Components of a Learning Disabilities Definition

Learning Disabilities:

1. is a general term for a heterogeneous group of disorders

2. are manifested by significant difficulties in listening, speaking, reading, writing, or math;

3. are part of the person make-up (i.e., they will not go away);

4. are presumed to be a dysfunction of the central nervous system;

5. may be discovered across the life span;

6. may RESULT in problems with behavior, social perceptions, and social interactions (but these problems are NOT the disability);

7. are NOT the result of other disabilities such as lost of sight or hearing, lack of intelligence, or lack of schooling.

OREGON DEPARTMENT OF EDUCATIONOregon Administrative Rules 9/19/2007SPECIFIC LEARNING DISABILITIES

A. Achievement Grades 1-121. Basic reading skills2. Reading fluency skills3. Reading comprehension4. Mathematics calculation5. Mathematics problems-solving6. Written expression7. Oral expression8. Listening comprehension

B. Other, if needed:1. Cognition2. Fine motor3. Perceptual motor4. Communication5. Social or Emotional6. Perception or Memory

OREGON DEPARTMENT OF EDUCATIONOregon Administrative Rules 9/19/2007SPECIFIC LEARNING DISABILITIES, Continued

Common Challenges of Successful Adults with LD

Almost all experienced significant difficulty learning in school

Many never did learn to read, write, spell, or compute particularly well

Social skills were either a strength or an area of need

Dealing with LD is a daily task Felt vulnerable because of differences in learning Self-esteem tended to deteriorate when LD went

undiagnosed

(Gerber & Reiff, 1994)

Consequences of LD Beyond School Failure

Poor peer relationships

Poor self-efficacy (ability to produce effects or intended results)

Poor post-school adjustments

Juvenile delinquency

Limited occupational status (under employment)

Mental Health Issues

Anxiety Depression Oppositional Defiant Substance Abuse Alcohol Drugs

Everyday Manifestations

Feeling constantly behind

Fear of filling out forms

Extreme stress or fear associated with any isolated measure of ability

Isolation resulting from fear of being misunderstood

Extreme stress over deadlines

Feeling inadequate because of difficulty doing tasks others find easy

Reading

Slow reader (estimated range up to four times as long to read a page as others)

Reading out of sequence (they went to see a movie=they to see a movie went)

Mistaking one word for another (for=from, to=of) Tracking difficulty: skipping over words or lines Difficulty reading multi-syllable words (aluminum) Difficulty with sound symbols relations Lack of vocabulary understanding & reading

comprehension

Spelling

Reversals common: d=b, friend=friend, (also number reversal: 0137=0317)

Frequently dropping, adding or reversing letters and word parts: know=now, bad, dog=dab dog

Difficulty mixing up words that sound the same; there=their, through=threw, where=wear, well=will, write=right

Forgetting how to spell commonly used words

Writing

Excessive time required to organize papers and thoughts Difficulty conceptualizing a paper’s overall topic and

formulating a thesis on the paper as a whole Tendency to laboriously work out specific parts of the paper

instead of focusing on the paper as a whole Letters reversed Freezing up when trying to write Spelling errors Illegible handwriting; cursive script difficult Words and letters out of sequence in sentences Difficult taking notes in class Completely omitting words or phrases Writing things that make absolutely no coherent sense

Testing

Seldom able to complete exams in class or national exams

Difficulty with multiple choice questions; difficulty filling in the bubbles on forms

Misinterprets directions or questions on exams

Extreme test anxiety

Concentration

Focusing requires extraordinary effort

Easily distracted by noise and movement

Memory

Difficulty recalling familiar things like one’s phone number, address, names of friends

Not remembering what was said or what you were talking about

Not remembering what the teacher/instructor said and trying to take notes

Frequently misplacing, losing or forgetting things

Not remembering what you saw or read, (writing down information from the chalk board or overhead/power point)

Speech

Difficulty pronouncing multisyllabic or uncommon words

Difficulty reading aloud

Stuttering or hesitancy in speech

Difficulty communicating ideas clearly

Orientation

Difficulty in distinguishing left and right

Directions, map reading, and navigating difficulty

Feeling lost in a familiar setting; easily disoriented

Ranges of LDJournal of Learning Disabilities, 29, 17-30

MILD average to above average intelligence

adequate psychological adjustments and vocational/employability skills

high academic achievement

limited processing and language skills

Ranges of LD, cont.Journal of Learning Disabilities, 29, 17-30

MODERATE average to above average intelligence

some cognitive and language deficits

one or more academic disabilities

some psychological adjustment problems

difficulty with vocational/employment skills

Ranges of LD, cont.Journal of Learning Disabilities, 29, 17-30

SEVERE display below average intelligence

significant cognitive processing and language deficits

low academic achievement

lack of psychological adjustment

lack of vocational/employment skills

Why Assess?

Determine eligibility

Determine strengths, abilities, and deficits

Determine appropriate instructional setting

Determine job match

Determine level of self-determination skills

Determine necessary accommodations, supports, and services

Primary Area Assessed Through Functional Assessment in Disciplines Related to Special Education

Function Area Constructs Measured

Behavioral/Psychosocial

Family Relations; personality;interpersonal relationships; behavioral surpluses and deficits

Communication Auditory and visual reception; oral and graphic expression

Cognitive Intelligence; attention, impulsivity;memory; problem solving; auditory,visual, and spatial perception

Physical Gross mobility; fine motor skills; strength and endurance

Primary Area Assessed Through Functional Assessment in Disciplines Related to Special Education

Function Area Constructs Measured

Daily Living Self-care; home maintenance; community awareness and use

Vocational Aptitudes; interest; academic skills; job seeking skills; job maintenance skills

Environmental Environmental demands; available support structures and practices

The functional areas and constructs measured presented are not exhaustive.

(Nelson, Roberts, Bullis, Albers & Ohland, 1999)

DIAGNOSTIC CRITERIA FOR ADULT LEARNINGDISABILITY DETERMINATION

There are several commonly accepted criteria that evaluators rely on when considering determination of whether or not an individual has a Learning Disability. Following are what appears to be the most commonly used criteria, keeping in mind that meeting only one of the following two criteria should not be used as the sole determinant of LD.

1. A significant discrepancy between overall cognitive ability and achievement in reading, math and/or writing as indicated by:

a) DSM-IV Edition-TR-Usually defined as a discrepancy of more than two standard deviations between achievement and IQ. A smaller discrepancy is sometimes used, (between one and two deviations), “especially in cases where an individual’s performance on an IQ test has been compromised by an associated disorder in cognitive processing, a co morbid mental disorder or general medical condition, or the individual’s ethnic or cultural background”;

b) A discrepancy of one and a half to two standard deviations;

c) Use of the regression formula;

d) A combination of discrepancies and professional judgment;

AND

2. The ability to process information is impaired in some way that is directly contributing to underachievement and is impacting the individual’s ability to learn or retain information in school, work and/or daily living activities.

DIAGNOSTIC CRITERIA FOR ADULT LEARNINGDISABILITY DETERMINATION, cont

Other Considerations The underachievement cannot be primarily due to factors other than a

processing deficit (e.g., lack of schooling, mental health issues, drugs and alcohol, hearing impairment, visual acuity problems);

With adults, a history of learning problems during their school careers is usually noted i.e., elementary, middle, high school. May have dropped out of school;

A history of learning problems in the family (e.g., parent/s, siblings, children);

Uneven development in cognitive and/or achievement areas. Full Scale Cognitive scores are normally within the average range or better, however, adults IQ’s who have had a history of school difficulties (may be drop outs) can be somewhat lower and in the low average range.

Determination of eligibility should not be made based only on one subtest.

Screening for possible social/emotional issues (e.g., depression, anxiety) and ADHD, which may be part of the LD assessment.

DIAGNOSTIC CRITERIA FOR ADULT LEARNINGDISABILITY DETERMINATION, cont.

Test Scores:

Care must be taken when analyzing cognitive, achievement and processing tests. A full scale IQ score in the Borderline range (70-79) does not necessarily mean an individual has Borderline intellectual functioning. When examining the subtest, full scale and Index scores there may be areas well within the average to above average range with significantly low subtest scores related to LD that make the client look Borderline functioning. A client with a Borderline Performance score and low to average Verbal score may appear to be borderline functioning if one relies only on the Full scale scores without taking into consideration variation in scores. A number of studies on low to borderline IQ are proving that individuals with low to borderline IQ may also have learning disabilities. Good diagnosticians don’t rely solely on the numbers. ( www.seakingwdc.org/ld/Formal Test.htm)

(Adapted from Washington State Learning Disabilities Project, Summary Report, 1998)

Characteristics of Diagnostic Testing

Is individually administered and scored; Can take from several hours to several days for testing

and several more days for interpretation of results; Can cost anywhere from $600 to $1,500, depending on

the extent of testing required for a diagnosis; Must be administered only by a qualified professional

who is licensed to administer psycho-educational test batteries;

Provides in-depth assessment of an individual’s skill areas; and

As a result of diagnostic testing, individual knows for certain whether he/she has a learning disability, including information on how the specific LD affects performance.

Information Processing and Related Disabilities

Input Process Output

Auditory

Visual

Tactile

Olfactory

Gustatory

Thinking*Abstract *Concrete Memory*Auditory *Visual*Long Term*Short Term Sequencing Organization Attention

Talking

Reading

Writing

Motor

*Fine *Gross

Fluency/Speed

Accuracy

Four Stages of Information Processing and Related Disabilities

1. Input Visual Perception Disability Auditory Perception Disability

2. Integration Sequencing Disability Abstraction Disability Organization Disability

3. Memory Short-term Long-term

4. Output Language Disabilities: Spontaneous and Demand Motor Disabilities: Gross and Fine Muscle

Coordination

Types of Assessment Instruments

Norm Referenced Wechsler Adult Intelligence Test-III

Woodcock-Johnson Psycho-Educational Battery

(Cognitive & Tests of Achievement)

Wechsler Individual Achievement Test

Nelson Denny Reading Test

Scholastic Abilities Test for Adults

Detroit Test of Learning Aptitude

Types of Assessment Instruments

Rating Scales Conners’ Adult ADHD Rating Scales-

Observer-Report Conners’ Adult ADHD Rating Scales-Self

Report Brown Attention-Deficit Disorder Behavior Assessment System for Children,

Second Edition, Self-Report College (18-25), Self-Report Adolescent (12-21)

Types of Assessment Instruments

Self-Report

Interview

Observation

Learning Disability Evaluation Report

(see handout)

Definition of Self-Determination

The attitudes and abilities requiredto act as the primary causalagent in one’s life and make

choices and decisions regardingone’s action free from undue external

influence or interference

[Source: Wehmeyer, M.L. (1997). Self-directed Learning and Self Determination. In M. Agran (Ed.), Student-directed Learning: A Handbook of Self-Management. Pacific Grove, CA: Brooks/Cole.]

Accommodations

An accommodation:

is any change needed to help the employee learn the skill required to perform the job.

It may mean:

Using different kinds of learning materials;

Using special equipment, such as a computer or a calculator;

Having a special tutor or work “buddy” to help on the job;

Using auditory aids and services.

An accommodation:

does not include making changes in rules to make it easier for the person with LD to perform the work than for other employees; and

should not create an “undue hardship” for the employer. It is not necessary to provide the most expensive accommodation, just one that will help the employee do what needs to be done.

Work Skills*What skills employers want -versus - What does the job require

The three R’s (reading, writing, and arithmetic).

Organizational effectiveness/leadership (the ability to get things done and to lead).

Self-esteem/goal setting-motivation/personal and career development (feeling good about what you are doing and where you are going).

Interpersonal skills/negotiation/teamwork (the ability to successfully work with co-workers).

Problem solving/creative thinking (the ability to overcome obstacles encountered by the worksite).

Listening and oral communication (the ability to interact effectively with co-workers).

Learning to learn (the willingness to learn new tasks/skills on the job).

*Carnevale, Gainer, and Meltzer (1988)

TOOLS

* Environmental School Assessment Measure - E-SAM

* Environmental Job Assessment Measure - E-JAM

*from: PRO-ED, Functional Assessment In Transition and Rehabilitation For Adolescents And Adults With Learning Disorders, 1999.

Environmental Settings and Demands for Clients

Demands of the job

Demands of the school

Demands of the training site

Demands of the classroom

Demands of DHS

Secretary Commission on Achieving Necessary Skill (SCANS report)

Physical demands

Working conditions

Educational demands

General work behavior

Social interaction

Common Strengths of Successful Adults with LD

Able to cope and compensate for LD

Determined to achieve

Willing to work hard

Found ways to learn that led to success

Recognized and accepted LD-“goodness of fit” in jobs/tasks assigned to them

Used technology

Recognized need for support and found/had it

(Gerber & Reiff, 1994)

What is Success?Quotes from Successful Adults with LD

Achieving a goal

Establishing a realistic goal and then achieving it

Overcoming overwhelming odds

Setting goals and attaining them

Being happy in whatever you do

Feeling that you have accomplished what you set out to do

(Gerber & Reiff, 1994

Assessment Instruments for Transition, Career Planning, Jobs

CAREER CLUSTERS

Crafts Scientific The Arts

ManualSkilled CraftsTechnicalMath-ScienceMedical-Dental

Math-ScienceMedical-Dental

LiteraryArtsMusicEntertainment

The Harrington-O’Shea Career Decision-Making System American Guidance Service

Assessment Instruments for Transition, Career Planning, Jobs

CAREER CLUSTERS

Social Business Office Operations

Customer ServicePersonal ServiceSocial ServiceEducation

ManagementLegal

ClericalData Analysis

The Harrington-O’Shea Career Decision-Making System American Guidance Service

Assessment Instruments for Transition, Career Planning, Jobs

Work Values

Outdoor Work Good Salary Prestige

Physical Activity Independence Variety

Risk Job Security Leadership

Work with Hands High Achievement Creativity

The Harrington-O’Shea Career Decision-Making System American Guidance Service

Assessment Instruments for Transition, Career Planning, Jobs

The COPSystemEdit/Educational & Industrial Service, San Diego, CA 92176

CAREER CLUSTERS1. Science Professional 2. Science Skilled

3. Technology Professional 4. Technology Skilled

5. Consumer Economics 6. Outdoor

7. Business Professional 8. Business Skilled

9. Clerical 10. Clerical

11. Arts Professional 12. Arts Skilled

13. Service Professional 14. Service Skilled

Assessment Instruments for Transition, Career Planning, Jobs

Enderle-Severson Transition Rating Scale (ESTR-J)(Transition assessment for adolescents with mild disabilities)Practical Press, PO Box 455Moorhead, MN 5661-0455

ESTR-J PROFILEJobs and Job Training

Recreation and Leisure

Home Living

Community Participation

Postsecondary Training & Learning Opportunities

Total Performance Score

Assessment Instruments for Transition, Career Planning, Jobs

The Arc’s Self-Determination ScaleThe Arc of the United States500 E. Border St. Suite 300Arlington TX 76010

SCALE PROFILEAutonomy

Self-Regulation

Psychological Empowerment

Self-Realization