SPM and SPM-2 Quick Tips Case Study: What’s Behind Challenging Behaviors in the Classroom?

The process of identifying, assessing, and starting early intervention for a developmental delay can be a long haul for families and practitioners. Often, weeks or months pass before a child’s needs can be determined and resources lined up to meet them.

As a practitioner, you can use the wait time to educate and empower families so they know what to expect and what supports may be available to them along the way. 

What lengthens the early intervention timeline?

The early intervention process occurs in phases. The first phase is recognizing the developmental delay. The second phase is identifying or diagnosing the reason for the delay. And the third phase is participating in an early intervention program. Many intersecting factors at the family level and at the service level can lead to delays in any of these phases.

For example, some parents or caregivers may take longer than others to recognize a developmental delay or to speak with a health professional about one. At the service level, funding, referral practices, staffing, and the proximity of assessment facilities can also mean longer wait times for an evaluation. In addition, eligibility criteria, a lack of specialists, and language barriers can all affect timelines in early intervention programs (Sapiets et al., 2021).  

How can we make the process better for families?

The guidance below has been consolidated from studies that sought the opinions of parents and caregivers involved in early intervention programs, and from the recommendations of the early intervention advocates and experts.   

Here’s an overview of the recommendations researchers and families have made. 

1. Explain the process in plain language. Waiting is often easier when we know what to expect. You may want to help parents understand these parts of the process:

• What the next steps are 
• What the approximate overall timeline is likely to be 
• What factors could lengthen or shorten the timeline 
• What each assessment will entail 
• Who will be involved at each stage 
• How to reach the professionals responsible for each process 
• What their rights and responsibilities are at each stage

You may want to take this time to establish a family liaison to be the main professional contact for answering questions and providing updates to the family. If language barriers exist, it’s important to minimize their impact by providing materials in a language parents can access and by working with interpreters as needed. The U.S. Department of Education provides language assistance in over 100 languages. 

There are many unknowns in early intervention, so it will help if you can fill in knowledge gaps whenever possible. You may want to supply a document like this Early Steps Record Keeping Toolkit, which parents can use to consolidate their notes, track progress, and keep up with contact information.  

2. Explore the family’s goals, concerns, perspectives, and priorities early on. This is no small task. It means that the practitioner plans to respond to the needs that the family has expressed, and will use interventions that are inherently respectful. This approach may mean that you need to make time for cultural awareness training for yourself and your team. It may also require changing some of your processes and creating new tools. The ECTA Center offers practice improvement tools you can use to engage families in the early intervention process. 

Studies show that while family-focused collaboration is relatively new, it can lead to greater quality of life and more effective interventions. In one study involving family-centered practices with children in early intervention in Ecuador, participants said that the child made developmental progress--and the whole family benefitted. “I also feel that we are more united as a family…and the truth is that we are calmer now with your help,” one mother reported (Frugone-Jaramillo & Gràcia, 2023). 

3. Connect families with resources. You can assist parents and caregivers by connecting them with family-led organizations and family-to-family health information centers where they can tell their stories, access free training, explore sources of funding for services, become engaged in advocacy work, and interact with other people on similar journeys. Some of these organizations are:

• Family Voices 
• Parent to Parent USA 
• National Federation of Families for Children’s Mental Health 
• The Center for Parent Information and Resources  

4. Help parents learn about their child’s educational rights. Some early intervention services are available through health and human service departments. Some are available through school systems. Understanding how to access these services in each setting is an important part of parenting a child with special needs. Some parent-friendly resources can be found here: 

• Reading Rockets: Rights and Responsibilities of Parents of Children with Disabilities 
• Special Needs Alliance: What Parents Need to Know about Special Education Rights 
• Special Education: A Basic Guide for Parents (National Association of School Psychologists) 

5. Coach families in completing helpful developmental activities at home. Many basic strategies can be practiced at home and in other natural settings with a little guidance from a professional. The Centers for Disease Control and Prevention offers resources for parents who want to encourage growth while they’re waiting for developmental assessments and interventions. The American Speech-Language-Hearing Association suggests these activities for developing language skills at home.

When parents have confidence in their role and actively participate in therapies, it can give them a way to regain autonomy and a sense of control. It can build closer bonds with a child, greater parental confidence, and keener sensitivity to a child’s needs.  

6. Invite families to engage as advocates. Head Start and other early intervention programs can empower families to act as advocates, both in securing services for their own children and in community and policy roles. You can share these practical tips for carving out time for advocacy in a busy family schedule.

It's important to recognize that not all families, parents, or caregivers will feel equipped or feel comfortable as vocal advocates. You may be able to use these Harvard Family Research Project strategies to make your clinic or classroom feel safer for those who want to advocate for their child’s needs.   

7. Communicate in varied ways. When researchers survey parents about their satisfaction with the early intervention process, ineffective communication is often identified as a barrier. It’s a good idea, then, to stay in touch with families throughout the waiting period.

In focus groups that met to discuss early childhood programs in Illinois, participants said they were grateful when centers relayed information about opportunities through parent-focused social media groups, television and radio ads, community calendars, and flyers sent home from school. One family member said, “There’s multiple ways of communicating so you’re never left in the dark…” (Bentley et al., 2023).  

8. Ask for feedback from the families you serve. In one Spanish early intervention program, researchers queried parents about their impressions during treatment. The survey results confirmed that parents were concerned about long wait times and the lack of flexibility in scheduling options—issues that arise frequently in U.S. early intervention programs, too.

But clinicians also learned about some practical concerns that were particular to their clinical facilities. For example, families said they needed a covered walkway to prevent children from getting overheated or wet on the trip from the parking lot to the clinic. Researchers said the survey gave families a chance to actively participate, which “makes the families feel as if they are part of the treatment” (Romero-Galisteo et al., 2020). In another study, researchers learned that carrying out assessments in the home or providing transportation to a clinic could make the process easier for families who lived a long way from the clinic (Sapiets et al., 2021). 

You may discover that there are simple measures you can take that will make the process smoother for everyone. 

Long wait times are an unfortunate reality in early intervention in the U.S.—but the wait time needn’t be wasted time. The steps you take now could make the early intervention process more efficient for you and more effective for families down the road.  

The corresponding webinar, Linking TOD® Results to Interventions,
is available on demand!

The score report for the Tests of Dyslexia (TOD®) is much more than numbers. It also explains and interprets scores, giving you some very important insights into a student’s strengths and needs, as well as the probability of dyslexia. With this plentiful data in hand, you can begin to chart a path forward—recommending strategies for IEPs, 504 plans, individualized instruction, and other supports. But how do you know which specific strategies to employ?

Enter the Dyslexia Interventions and Recommendations: A Companion Guide to the Tests of Dyslexia (TOD). This detailed resource, referred to as the TOD Intervention Guidebook, contains specific teaching and support strategies you can map to directly from TOD scores.

Barbara Wendling, MA, is co-author of the TOD, an experienced diagnostician, and a dyslexia interventions expert. She has co-authored several books in the Essentials of Assessment series, including Essentials of Dyslexia Assessment and Intervention and Essentials of Evidence-Based Academic Interventions. She joins WPS ProLearn® for the webinar Linking TOD® Results to Interventions.

Here's her guidance for putting the companion guide to good use following a comprehensive dyslexia evaluation. 

You can use the TOD Intervention Guidebook to link a test result to explicit, systematic reading instruction in an identified area of need.  

Test results are important for understanding whether a student qualifies for services; TOD reading, spelling, and linguistic processing composite scores and its Parent/Caregiver and Teacher Rating Scales show you exactly which skills need support. 

“When we were developing the blueprint for the Tests of Dyslexia and looking at all the important linguistic and academic reading-related areas that we wanted it to cover, it was a natural addition to the plan to say, ‘Let's help the teacher side of this equation by connecting the testing results to specific interventions for the areas that the test may have found as weaknesses,’” Wendling explains. “We wanted to something meaningful to come from the testing result.”

This continuum of service is part of what makes the TOD a comprehensive assessment tool. “That’s one thing that’s special about the tests. Whether the issue is in phonemic awareness or in orthographic mapping or something else, you’ll be able to take the information in the Intervention Guidebook and dig right in with an understanding of what you can do immediately for this person.” 

You can use the TOD Intervention Guidebook to plan instruction grounded in the Science of Reading—for all reading levels in your classroom.

“In any classroom, you will have a range of reading abilities present—some students that are well below grade level and some students that are well above grade level. That, in itself, is a quite a challenge for teachers,” Wendling says.  

Because needs vary so widely, the authors compiled evidence-based interventions that researchers have found are most effective across all critical areas of reading. Each intervention is grounded in the Science of Reading.  

Wendling stresses that it’s important to understand what is meant by ‘Science of Reading’. “It is not a program. It is not a step-by-step guide. It’s research that has identified how we learn to read, why we don’t read, and what generally works best in terms of working with these students.”  

In designing both the assessment and the interventions, the co-authors followed decades of research. “I can assure you that these interventions are evidence-based,” she says. 

You can share the reproducible Appendix, “Teaching Students with Dyslexia” to deepen dyslexia knowledge across your whole team.

Wendling points out that not everyone on an evaluation team specializes in reading. For that reason, this companion guide contains a shareable chapter to help general education teachers and other professionals grasp the issues that underlie reading difficulties and how to address them. 

“The Appendix is specifically designed for general education teachers, special education teachers, and other educators,” she notes. “It will help them understand what dyslexia is, it provides an overview of the framework of all the interventions in the guide, and it will help them understand what accommodations might be necessary for a student to succeed. I like to view it as a mini crash course in reading.” 

Key Messages

A dyslexia evaluation involves carefully building a picture of a student’s needs and abilities that’s as complete as possible. You will want to gather data from many sources, including reliable, validated assessments. The TOD yields important information for a student’s holistic reading profile—and in using the TOD Intervention Guidebook, you’ll be able to put that information to use right away. 

“An assessment should be so much more than scores,” Wendling says. “All of us on the author team have had classroom teaching experience and testing experience, so all of us felt that interventions were equally important to developing a comprehensive test…and this guide helps you to implement systematic, explicit instruction across all of the critical areas of reading.” 

For a deeper understanding of how to plan interventions using TOD test results, watch the on-demand webinar here. 

This blog was updated on 2/14/2024

The best and most appropriate sensory toys and materials for autism can reveal key details about a child’s abilities and development—but they also can serve as a gateway to a closer and more trusting relationship with the child throughout an evaluation process.

Formal assessments certainly provide essential information, but interesting sensory materials can establish a more authentic connection with the child—or verbally fluent adult—that elicits a better understanding of his or her worldview, according to author Dr. Marilyn Monteiro, PhD.

Monteiro has evaluated more than 4,000 children on the autism spectrum and trained hundreds of educators and clinicians in diagnosing and understanding individuals on the spectrum. She discovered near the beginning of her 30-year career that when conducting an evaluation, behavior rating scales and standardized assessment measures just weren’t enough.

“What was lacking for me was having that instant connection with the child, being able to put the child or teenager at ease, and getting to know what makes their brain tick—what things make their brains alert and engaged, and discovering what they are passionate about,” said Monteiro.

This list of sensory materials originally appeared in Marilyn Monteiro’s 2010 book Autism Conversations: Evaluating Children on the Autism Spectrum through Authentic Conversations. Learn more about the MIGDAS-2, which includes updated information for building a sensory-based materials kit.

Research and Resources: 

Binns, A. V., Casenhiser, D. M., Shanker, S. G., & Cardy, J. O. (2022). Autistic preschoolers' engagement and language use in gross motor versus symbolic play settings. Autism & Developmental Language Impairments, 7, 23969415221115045. https://doi.org/10.1177/23969415221115045

Centers for Disease Control and Prevention. (2023). Community report on autism 2023. https://www.cdc.gov/ncbddd/autism/pdf/ADDM-Community-Report-SY2020-h.pdf 

Ciuffo, L. L., Souza, T. V., Freitas, T. M., Moraes, J. R. M. M., Santos, K. C. O. D., & Santos, R. O. J. F. L. D. (2023). The use of toys by nursing as a therapeutic resource in the care of hospitalized children. Revista Brasileira de Enfermagem, 76(2), e20220433. https://doi.org/10.1590/0034-7167-2022-0433

Kirby, A. V., Bilder, D. A., Wiggins, L. D., Hughes, M. M., Davis, J., Hall-Lande, J. A., Lee, L. C., McMahon, W. M., & Bakian, A. V. (2022). Sensory features in autism: Findings from a large population-based surveillance system. Autism Research, 15(4), 751–760. https://doi.org/10.1002/aur.2670 

Roy, M., Kinlin, C., & MacEachern, S. (2022). Implementation of a sensory toolkit in the emergency department for children with autism spectrum disorder. Paediatrics & Child Health, 27(Suppl 3), e23. https://doi.org/10.1093/pch/pxac100.048

Unwin, K. L., Powell, G., Price, A., & Jones, C. R. (2023). Patterns of equipment use for autistic children in multi-sensory environments: Time spent with sensory equipment varies by sensory profile and intellectual ability. Autism, 13623613231180266. Advance online publication. https://doi.org/10.1177/13623613231180266 

AUTISM RESOURCES  

Further Reading on Autism 

• Creating Autism Friendly Spaces 
• The WPS In-Depth Guide to Autism and ADHD  
• How Autism Can Look and Feel Across the Lifespan 
• Why So Many Autistic Girls & Women Are Still Missing Out on Early Identification 
• Understanding the Complicated Interplay of Autism and ADHD 
• How Autism and ADHD Can Disrupt Interoception 
• How to Choose the Best Autism Assessment for Your Client 
• Best Practices in Autism Assessment 
• Autism Conversations: Individualizing Educational Interventions with the MIGDAS-2 Evaluation Process 

Videos and Webinars on Autism 

• How Cyberbullying Impacts Students On and Off the Autism Spectrum 
• Conversation Over Labels: A Better Way to Understand Autism 
• Autism Spectrum Brains 'Get Energy' from These Things 

The classroom door swings open, and one of life’s most important transitions begins. A child enters the school years. Stepping into kindergarten may look like crossing a single, tiny footbridge, but it’s actually a collection of them. And a 2024 study published in Early Childhood Research Quarterly suggests that a child’s later success may depend more on how smooth the transition is than on how much advanced preparation a child has had.  

The Link Between Transition Trouble and End-of-Year Skills

Researchers looked at longitudinal data on academic and social growth in a sample of 801 kindergarten students in 15 Ohio schools. They paid special attention to teacher-reported “transition difficulties” that occurred between 10 and 14 weeks into the kindergarten school year.

After controlling for individual and family characteristics as well as classroom differences, researchers found that having less trouble transitioning was associated with greater math, reading, and social skills by the end of the school year. The link between transition difficulties and end-of-year achievement remained clear even for those children who had strong academic and social skills at the start of kindergarten.

An earlier study showed that roughly 70% of kindergarten students had trouble adjusting to one of the following aspects of kindergarten life:

• Making new friends among classmates 
• Keeping up with rules, routines, and schedules  
• Learning new academic skills 
• Working in groups 
• Getting and staying organized

Around 30% of students had difficulties with all five kindergarten-transition skills (Jiang et al., 2021).  

What Do Researchers Recommend?

Early learning experiences do help prepare children for school. Even so, they don’t guarantee a smooth entry. To make transitions easier, the study authors recommend these strategies:

• Align preschool and kindergarten instruction. Educators in both environments can communicate about common strengths and challenges, coordinate learning objectives, and create similar classroom experiences.

• Build connections. School leaders can share information about kindergarten with families and communities, host “school success” orientations, and organize school visits before the school year gets underway.

• Provide interventions early. Observant classroom teachers and caregivers can work together to identify adjustment issues and arrange supports early in the year (Sun et al., 2023). 

Key Messages

Early learning experiences can equip preschoolers with many of the skills they’ll need in kindergarten—but significant differences exist between the two learning environments. Easing the transition from one to the other can lead to greater math, reading, and social skills by the end of the kindergarten year.

To minimize transition difficulties, preschool and kindergarten teachers can bring academic goals into alignment. They can create more similar classroom experiences. And they can interact with communities and families so everyone knows what to expect during this challenging shift.   

As any mental health practitioner knows, personal history has a way of seeping into daily reality. The same principle holds true for fields of study. The history of psychology influences its current policies, practices, and perspectives. Nowhere is that more evident than in IQ testing.

Intelligence testing has a history fraught with discrimination and even oppression. Through decades of advocacy, education, and justice initiatives, change is happening, but inequities still exist in the way we measure intelligence and use assessment data.

Linda McGhee, JD, PsyD, is at the forefront of the movement to make psychological, educational, and intelligence testing more equitable. She is the co-founder of the Multicultural Assessment Conference, a forum for professionals pursuing greater skill in evaluating people who are culturally and linguistically diverse. And she is host of the upcoming WPS ProLearn™ webinar “Reconsidering Intelligence Tests for Multicultural Populations in Schools,” in which she explores the history of intelligence testing in the U.S., the intentions of credited inventors like Alfred Binet, and guidance for equity-focused assessment practices.  

Understanding a History of Testing Injustice 

“When we look at the history of the IQ test, we see that Mr. Binet created a test merely to measure where fifth graders were in school,” Dr. McGhee says. Despite Binet’s warnings about the potential misuse of IQ tests, when these measures began widespread use in the U.S. they quickly became instruments of discrimination in biased systems.

Intelligence tests have been used to support racist hierarchies in which some citizens benefitted, and others suffered profoundly. IQ test scores have been used to:

• determine who would be allowed to immigrate or seek asylum (Garland, 2006); 
• funnel students into substandard educational “tracks” (Kanaya, 2019);
• justify the death penalty in criminal cases (Sanger, 2015); and
• select thousands of people for involuntary sterilization in the U.S. (National Human Genome Research Institute, 2022).

“That’s the context,” Dr. McGhee explains. “We’re not just going into a room and testing a child. We’re testing in the context of history that cannot be ignored by clinicians.” 

Addressing Current Inequities 

In recent years, many intelligence tests have been reviewed, revised, and re-normed in wider, more representative populations. Even so, the outdated racial and ethnic hierarchies these tests informed are still contributing to health and education inequities today. 

Professional organizations such as the American Psychological Association recognize the historic and persistent damage. Organizational leaders urge practitioners to study the past and move toward a more inclusive, comprehensive view of intelligence. While the list below is not comprehensive, these assessment strategies are a starting place for building more equitable intelligence assessments.  

1. Evaluate each person in context.

Culture is known to affect several cognitive processes, including problem solving, auditory processing, language proficiency, and decision-making speed, among other skills. Researchers say “school psychologists in both research and practice should focus more on examining the broad abilities and subprocesses…from an equity perspective” (Holden & Tanenbaum, 2023).  

Dr. McGhee adds, “We now know that race and ethnicity have a been a proxy for socioeconomics, having less access to quality education, and healthcare. We thought we were measuring IQ, but part of IQ is what you’ve been exposed to and the kind of life you’ve led before you come into Dr. McGhee’s office for that IQ test.” 

2. Take a strengths-based approach.

Deficit thinking is sometimes described as the idea that differences in performance usually stem from personal strengths or weaknesses instead of external influences. Researchers think that deficit thinking may reinforce stereotypes and hide individual variations within groups (Holder & Ziong, 2023).

“We need to be aware of looking for gifts and taking ourselves out of the deficit model,” Dr. McGhee says. Instead, she recommends developing a “habit of describing children and what they’re good at and using language that talks about challenges but also talks about strengths.”  

3. Examine your own perspectives and practices. 

Implicit biases are often described as “mental shortcuts” people take when interacting with others. People in helping professions are not immune from them—and they often lead to inequities in health care and education.

“As clinicians, we want to believe that because we are in helping professions that we don’t have those kinds of unconscious processes—but the existence of these unconscious biases has been proven over and over,” Dr. McGhee says.

For example, a 2023 scoping review found that persistent biases were “widespread amongst health professionals.” In this review, racial biases shaped practitioners’ expectations for patient behavior, the language they used to describe patients’ compliance with treatment, and the amount of “verbal dominance” they used when communicating with their patients (Meidert et al., 2023). Learning about racially based health disparities and cultural competence can reduce these biases, especially when learning is coupled with strategies that change the environment, such as increasing the amount of interracial contact clinicians and educators have (Vela et al., 2022). 

4. Be aware of the uses of testing documents.

The results of intelligence testing can have profound and long-lasting impacts on the lives of clients, students, and their families. For that reason, it’s especially important for clinicians and educators to use care when identifying conditions and making recommendations. It’s also vital that families understand how reports can be used to help or hinder their goals. 

“The testing document should be a living advocacy document,” advises Dr. McGhee. “That document is going to go someplace—into an IEP room, to an employer. So be a smart, culturally aware conduit for your client, taking them through the processes before and after the testing. All of this goes into becoming a culturally aware practitioner.” 

Key Messages

The history of IQ testing is troubling—and there is ample evidence that scores on intelligence tests are still used in ways that harm many of the people they are supposed to help. Fortunately, there is also some evidence that clinicians, educators, and researchers are taking steps to define and measure intelligence in ways that are more equitable to everyone.

“The good news is that we’re learning about more various groups and IQs,” says Dr. McGhee. “The gaps between races are closing. And we also understand that what we are measuring encompasses socioeconomics, quality of education, opportunities in the home, where you live in this country (because school funding is based on home taxes), health care, food, and trauma—all of this goes into what a child could score on a certain test.” 

When it comes to early literacy, all eyes are usually on the classroom teacher—and rightfully so. Systematic, explicit reading instruction is essential if students are to develop strong reading skills. But in many important ways, principals and assistant principals act as the guardians of early literacy. They can create an environment in which teachers, students, and families are empowered to focus on building those foundational skills.

Chris Rangel, EdD, is principal of Ann Windle School for Young Children in the Denton Independent School District in Texas, where early literacy is a prime focus for educators and families. Denton, TX, like most urban school districts, has a wide range of household incomes and economic markers. Some children come to school with experiences of poverty, and Dr. Rangel emphasizes that it’s crucial to ensure all students have access to engaging literacy interventions. 

“The formative years are critical in the development of young learners for a multitude of reasons, but when focused on academics, their early development in literacy can impact the long-term success they obtain in subsequent years,” Dr. Rangel says.

Here’s a look at the strategies Dr. Rangel and her team use to encourage early literacy achievement schoolwide. 

Focus on essential learning standards.

Many pre-kindergarten teachers work alone, and they’re often charged with teaching many, many standards over the course of a school year. In the state of Texas, where the Ann Windle School for Young Children is located, pre-K standards are outlined in a document that spans more than 80 pages. Some states identify essential standards; others do not. In districts that do not identify essential standards, teachers may feel overwhelmed and uncertain.

Dr. Rangel says one way to determine which standards will lead to the largest impact is to ask questions like these:

• How enduring is each standard? How valuable is it for life and lifelong learning? 
• Does it prepare students for the next level of learning? 
• Does it have value across many disciplines?

Evaluated this way, it’s clear that early literacy standards are among the most essential.  

Protect literacy time.

For Dr. Rangel, this includes protecting professional development time. It also includes intentional, structured times for literacy development every day. What might that look like in a teacher’s daily lesson plan? 

• At least three read-alouds across a variety of subjects  
• Two modeled, shared, or interactive writing or writing-readiness activities  
• Time for independent writing 

To lay the groundwork for these daily activities, teachers can take steps like these:

• Make books available in each classroom center. 
• Encourage students to label what they draw. 
• Label items throughout the classroom. 
• Place letters in high-visibility spots.
• Ask students to “write” letters in the air.
• Ensure that writing tools are available readily.
• Provide beads, clay, and other materials with which students can shape letters. 

Read aloud with purpose.

The joy of sharing a picture book with young readers is hard to match—and in an early learning setting, even more can be gained from this happy practice.

“We know that reading to students is without exception critical for literacy development,” Dr. Rangel explains. “Within a read aloud, there are numerous opportunities that can occur for this development—concepts about print, letter/sound association, oral language and vocabulary development, questioning, making connections, etc. If a teacher is not maximizing these opportunities during read-aloud time, support in the form of coaching, modeling, observation, and/or professional development might be needed. My job as the instructional leader is to not only facilitate this support, but then provide follow-up feedback.” 

Include activities to support social-emotional literacy.

Pre-school, kindergarten, and early elementary are environments in which social–emotional learning is continuous. Children use social language and practice social skills like empathy at recess, in reading circles, in classroom centers, and in the cafeteria. When educators talk about conflicts, name emotions, and provide comfortable places for dysregulated students, they are modeling important skills.  

In many districts, skills such practicing empathy, interpreting other people’s needs, and using ‘soft hands’ are explicitly taught as part of ‘conscious discipline,’ Dr. Rangel says. These watchwords—Be safe, Be kind, Be ready—provide an opportunity for students to “use words to explain what each means,” she says.  

Provide the training teachers need.

Opportunities for systematic, explicit instruction are plentiful in early learning settings. To ensure that teachers feel equipped and supported, opportunities for training are also plentiful. That’s a key responsibility for administrators, Dr. Rangel believes. 

“We spend a great amount of time supporting the development of our teachers, so they feel equipped to maximize student learning,” she says. “For example, when essential learning standards are determined, there is then a series of backward planning that occurs to ensure we know what the end goal is and that we have planned for rich and purposeful experiences to support our students in reaching that goal. One of my jobs is then to support the teachers by building their capacity in effective instruction.” 

Training like this is not a one-time yearly task. “This work is never done, as we are continuously refining our practices—but building the capacity of teachers is always a way administrators should be supporting student learning,” she says. 

Recruit families and communities in literacy-building. 

This can be a challenging endeavor, especially if families are reluctant to trust school leaders and systems. “By nature, our beliefs and prior experiences form how we view situations,” Dr. Rangel explains. “If your own experiences in school were not positive, this is how you might view your child's entrance into school.  As a result, it is our responsibility to potentially change that mindset.” 

For educators and administrators at the Ann Windle School, change begins with frequent, positive communication. “When we only communicate negative information or we miss opportunities to try and engage our families, the relationships either suffer or are never built,” Dr. Rangel says. “As a result, we encourage positive contact with families–positive notes home for each child by week three of the year, electronic portfolios where artifacts are uploaded weekly, opportunities for families to serve on committees and attend afterschool campus events throughout the year, Meet the Teacher and Family Information Nights within the first two weeks of school, and conferences and home visits twice a year.”

Family, community, and cultural assets can also be valuable tools for building literacy. They can be leveraged to build more meaningful and trusting connections between home and school. Here are a few opportunities to share varied languages, values, traditions, and assets:

• Parent conferences provide a chance for parents and educators to set goals together.  
• Volunteer opportunities can help parents feel included and valued.  
• Family literacy and STEM nights offer opportunities to connect and learn.  
• Parent surveys give families a voice in sharing their needs and priorities. 
• Resources such as health screenings and training opportunities can be offered through libraries, community centers, and recreation facilities. 

“We know many of our families are single-income families where the parent might be working more than one job” she points out. “Our families might not be able to volunteer their time during the school day, but engagement and involvement can look different than that, and it is okay!  We also blast out flyers and videos of activities to do at home with students—cooking, reading, crafts, etc.—so that they can support the development of their child in any way they can, whenever they can.” 

When families and educators join in the effort to prioritize early literacy, outcomes for students can change in meaningful ways. Dr. Rangel says, “We are beginning to see our students more prepared as they move into the comprehensive elementary campuses with the intentional work we are conducting. Our students are gaining critical skills in their development that are imperative for their continued success.” 

The Key Message

Principals and other school leaders have a vital role to play in shaping literacy development in the early years. They can empower teachers, focus instructional aims, prioritize literacy in classroom spaces and schedules, and support literacy-related family connections. When administrators champion literacy in these ways, the results for students can be life-changing because of the rapid skill development that takes place in early learning.

“What occurs during these two years directly correlates to the trajectory of their progress as they move forward,” Dr. Rangel says. “It is actually quite remarkable to watch and to get to be a part of.”  

Researchers have long known that infants perceive and respond to the rhythms of human speech well before they grasp the sound or meaning of words. As far back as 1988, studies have shown that newborns and 8-week-old infants could tell the difference between their home language and another language based on rhythmic cues (Mehler et al., 1988). Infants can also detect the intervals between vowels and consonants—and because these intervals differ from language to language, even young infants show a preference for the rhythms of their home language (Gasparini et al., 2021). 

Furthermore, infants seem to be able to distinguish between speech and non-speech rhythms. For example, EEG data in one study showed that 8-week-old babies could discriminate between the rhythms of repeated syllables and drumbeats (Gibbon et al., 2021).

New studies are exploring how these rhythmic skills relate to overall language development. Some suggest that an infant’s ability to track rhythmic speech may predict later language abilities.   

Tracking the Bouncy Rhythms of Nursery Rhymes

In a 2022 study, researchers examined EEG data on 4-, 7-, and 11-month-old infants as they listened to nursery rhymes. Why nursery rhymes? Because their patterns of stressed syllables emphasize word boundaries. And nursery rhymes can be sung or chanted to enhance their rhythmicity. Data from all 3 age groups showed that nursery rhymes produced a synchronized response in brain activity, indicating that the infant brain was paying attention to the rhythms even though the babies could not yet understand the words (Attaheri et al., 2022).

In a follow-up study, researchers measured language acquisition for the same group of children using infant-led measures and parent estimates. Differences in how the infants responded to sound were associated with their language outcomes (Attaheri et al., 2022). 

More recently, researchers in the BabyRhythm Project at the University of Cambridge found that 7-month-old infants listening to nursery rhymes were building new capabilities on the foundation of their rhythm knowledge. They were beginning to encode phonetic information—categories of specific sounds—in addition to rhythmic information (DiLiberto et al., 2023). Researchers say putting rhythm information and phonetic information together could be the start of understanding where words start and stop in the baby’s home language.  

Rhythm Response as a Biomarker for Dyslexia

How an infant responds to different rhythms may someday be used as a clinical biomarker to help practitioners predict reading and language difficulties later. We’re not there yet: The process of identifying dyslexia does not yet involve brain activity data. Still, researchers are exploring these links through a number of recent studies.

For example, in several studies, dyslexia was associated with a difference in the ability to process the low-frequency sound information associated with speech (Molinaro & Lizarazu, 2018; Keshavarzi et al., 2022). To process speech efficiently, neurons must fire at an optimal moment in response to sound stimuli. In children with dyslexia, the neurons have a different preferred firing phase—making language processing less efficient and possibly less accurate (Keshavarzi et al., 2022).

Differences in rhythm processing have also been linked to developmental language disorder (Ladányi et al., 2020). Researchers say evaluating rhythm response could someday become part of the screening process for developmental language and reading conditions.  

The Key Message: Early Language Exposure Matters

Children who hear more adult talk tend to vocalize more themselves. Researchers used machine learning to analyze over 2,500 day-long audio recordings of the natural environments of children from 2 months to 4 years old. They found that the amount of adult speech children heard predicted the amount of speech they would create. These results were consistent across lots of different environments—urban and rural, in 12 countries, and on 6 continents.

In addition, researchers found that a child’s early speech-like vocalizations were a good indication of how much language the child knew, not just how “chatty” a child was (Bergelson et al., 2023). All of this confirms the importance of early speech and language exposure, whether it’s through song, infant-directed speech, or the baby-friendly beats of Mother Goose. 

If you work with young children, whether in early intervention programs or early education, WPS is pleased to be able to support your efforts with validated assessments, training, and other resources.  

Becoming a culturally sensitive practitioner is not an overnight endeavor—but it’s one that benefits everyone involved in the assessment process. Linda McGhee, JD, PsyD is an attorney, psychologist, and co-founder of the Multicultural Assessment Conference. She explains why it’s vital that practitioners approach psychological assessment with cultural awareness.

First and foremost, the possibility of misdiagnosis is much greater without it. “When people are misdiagnosed, it can affect their life trajectory and even their life expectancy,” Dr. McGhee says. Medications, education, health, and employment can all be influenced by a diagnosis that didn’t consider important cultural factors.

“We’re talking about culture in a broad sense,” she notes. “Race, ethnicity, gender, LGBTQ status—any way that culture can impact someone.” 

The need for cultural competence in assessments is growing. “This country is changing demographically—and it’s changing rapidly—far beyond the expectations of demographers and census-takers,” Dr. McGhee says. “The very essence and fiber of America are changing, and psychologists have to be at the forefront, making sure we are ready for those changes in the assessment room.” 

This webinar focuses on culturally competent assessment practices, beginning with an overview of research on an increasingly diverse U.S. population. Participants explore the unique developmental and environmental challenges many populations experience. They’ll also use case examples to investigate how culture shapes assessment outcomes—and how culturally astute practitioners can interpret them sensitively and accurately. 

“It’s putting the tests in context,” Dr. McGhee says, “and the context is the person’s lived experience.”

In any evaluation, the client’s and the clinician’s lived experiences meet face to face. For that reason, self-examination in a safe environment is a key component of this webinar. “It starts with the clinician being aware that their own perspective colors what they write and how they test,” she says. “We are not blank slates.” 

Cultural awareness also shapes these aspects of the assessment processes: 

• Selecting appropriate tests and subtests 
• Deciding whether to request consultation or supervision 
• Preparing the client, parents, and others for the process 
• Gauging your own expectations 
• Setting the tone in the assessment room 
• Adopting a strengths-based approach 
• Writing your report sensitively 
• Explaining to stakeholders how a report can be used

Developing such skills is the work of a lifetime. It takes time, openness, and an ongoing devotion to learning. “It's not always a smooth process. As with everything else you learn, you’re going to make mistakes. It’s not always going to be comfortable. If you can accept that you’re on a lifelong path to becoming more culturally competent and that the path is not always linear, then you can change. Any great movement, any great change, any great elevation of your field, your talent, and your gifts is similar.” 

WPS invites you to dive into this on-demand webinar—whether you’re taking your first steps or your next steps in the journey toward cultural competence in assessment. See learning objectives and contact hour information here.

Labels are for peanut butter jars—not people. With a neurodevelopmental condition as complex and heterogeneous as ADHD, a successful evaluation involves much more than assigning a diagnostic label. Clinicians and educators also need to assess a wide range of possible co-occurring conditions, mental health impacts, educational needs, sensory sensitivities, cultural influences, and trauma histories.

Board-certified pediatric neurologist J. Thomas Megerian, MD and board-certified behavior analyst and neurodevelopmental pediatric psychologist Jina Jang, PhD have extensive experience working with neurodiverse children and teens. In the upcoming webinar, ADHD: Beyond the Label, offered through WPS ProLearn®, Dr. Megerian and Dr. Jang will describe the evolution of ADHD as a historical diagnostic entity and over the lifespan of the individual. They will focus on three crucial aspects: the developmental stages of executive functioning, ADHD assessment, and best practices for managing the condition.

Assessing ADHD is challenging for a host of reasons. Some are clinical; some are personal or logistical. “One of the bigger challenges is that we have to see ADHD symptoms in more than one setting, so we need multiple sources of information,” Dr. Jang explains. “When we’re just seeing people in one visit, we often need behavior information and observations from school and from teachers. That takes a lot of coordination between us, parents, school settings, and therapists.”

Overlapping symptoms present another challenge. At the Thompson Autism and Neurodevelopmental Center at Children’s Hospital of Orange County (CHOC) in California, Dr. Jang and Dr. Megerian often see children and teens when other clinicians haven’t been able to identify which condition is causing symptoms.

“I saw someone yesterday who has ADHD but was also being evaluated for bipolar disorder,” Dr. Megerian says. “When we went through the screening criteria for bipolar, a lot of the symptoms were really attributed to ADHD. The symptoms that mimic bipolar are episodic, whereas with ADHD, they’re present all the time. It’s a persistent set of symptoms that doesn’t wax and wane.” Learning disabilities, anxiety, and a host of other conditions can cause symptoms that look like ADHD, and it takes specialized training and experience to differentiate between them.

Evaluations become even more challenging when people have two or more conditions at the same time. “At least half the time, ADHD occurs with something else. So, on top of making sure you’ve done the proper screening and treatment for ADHD, you need to make sure you’ve screened for other potential problems such as conduct disorder, oppositional defiant disorder, and anxiety disorder,” Dr. Megerian notes. Dr. Jang and Dr. Megerian will also examine other complexities, such as sex- and gender-related variations and societal barriers that can keep people from accessing good ADHD care or even influence a diagnosis.

Beyond diagnostic challenges, this WPS ProLearn webinar offers you an in-depth look at executive functioning across child development stages, which is vital for clinicians and educators working with children and teens. “At each developmental phase, a different level of attention and focus is required or necessary,” Dr. Jang says. “It’s important for parents and clinicians to understand what’s age-appropriate so we can accurately assess and diagnose ADHD symptoms.” 

Dr. Megerian and Dr. Jang will also bring webinar participants up to date on treatments and interventions that are making a difference in symptoms and quality of life.

“At the Thompson Center, we really believe that behavior therapy is an important first step before trying medication, especially when it comes to young children,” Dr. Jang points out. “Research has shown that parent training and behavior management is as effective as medication for treating symptoms in young children—but there are children who require more than that. We are able to recommend and provide that combined treatment for those kiddos who definitely need it.”

Advancements in first-line medication therapies are also a core component of the webinar. Stimulant and non-stimulant medications, new generic and abuse-resistant options, and combination therapies are “what some clinicians are excited about,” Dr. Megerian says.

WPS is pleased to highlight the work and expertise of Dr. Jina Jang and Dr. J. Thomas Megerian in ADHD: Beyond the Label—and we hope you’ll join us for this 3-hour, 3 CE intensive learning opportunity.  Registration is open. We hope to see you there! 

The summary below is based on an actual case example from the TOD authors Nancy Mather, PhD, Sherry Bell, PhD, Steve McCallum, PhD, and Barbara Wendling, MA. We’ve changed the personally identifiable information to protect the privacy of the student and his family.  

Background 

David Ruben is an adult with a long history of reading and spelling difficulties. His preschool teachers initially misread these difficulties as an intellectual disability or behavioral condition. By the 4th grade, however, David was transferred to a general education class. There, he continued to have trouble with reading aloud and spelling but excelled in math and music. 

Two of David’s sisters, his father, and his grandfather have a similar academic history, including one sister who was diagnosed with a specific learning disability. David received informal academic support sporadically throughout school, and succeeded in college and graduate school largely because he is highly motivated, and his business courses didn’t require much writing. He also used technology to help him overcome some of the limitations he has in reading and spelling. As an adult, David also received an ADHD diagnosis.

David trained as a stockbroker, a career that capitalized on his considerable math, finance, and social skills. Later, he became a Certified Financial Planner. He’s asked for this evaluation to determine whether he has dyslexia and might be eligible for accommodations on an upcoming retake of the Chartered Financial Analyst (CFA) exam, which he’s failed once and which involves intensive reading and writing.   

Test Strategy

Having learned about David’s experiences in school, we were not surprised to find that there were large discrepancies between David’s reading and spelling skills and the skills he’s developed in math.  

Reading and Spelling Tests 

David’s scores on all the reading and spelling tests in the TOD-C were low. His Reading and Spelling Index (RSI) score was 72, which is in the Well Below Average range. Here are a few takeaways from his assessment:  

• David used coping strategies to help him as he read. For example, he sometimes whispered the words as he read or held his place in the text by placing his finger on the line.  

• David had difficulty reading pseudowords and multisyllabic words. This told us he has to work extra hard to apply the rules of phonics when pronouncing unfamiliar words—which slows him down.  

• David tended to spell words as they sound instead of how they look. One example from the test: Croquet was spelled “crokay.” Spelling errors were common in words of more than two syllables.  

Vocabulary and Reasoning Tests  

David’s assessment included two measures of vocabulary, both of which fell in the Below Average range. These scores may reflect his avoidance of reading. By contrast, his scores on measures of reasoning ability are considered Above Average. It’s our view that these high reasoning scores make sense, given his math skills, postsecondary academic achievements, and work experience.  

Woodcock-Johnson IV Tests of Achievement (WJ IV ACH) 

David scored in the 83rd percentile on the Applied Problems test, which is unsurprising given his achievements in math and finance. Similarly, he scored in the 74th percentile on the Calculation test.  

TOD-C Self-Rating Scale  

David reported that he has ongoing difficulty with basic reading skills, especially longer words. He noted that his reading isn’t particularly fluent or efficient. Those difficulties carry over into his spelling and speaking abilities. David said he would rather listen to reading or involve himself in activities that don’t require reading at all.   

Based on these responses, David’s T-score on the rating scale was 71, which indicates a Very High Risk of dyslexia.  

Diagnostic Impressions 

Based on our observations, David’s self-report, and his test scores, these diagnoses are appropriate:  

• F81.0. Specific Learning Disorder with Impairment in Reading (Difficulties with reading rate or fluency), Moderate, Current.  
• F90.1 Attention Deficit/Hyperactivity Disorder, Predominantly Inattentive Presentation, Moderate, Past. 

Recommendations for Accommodation

Given David’s phonics knowledge, spelling skills and reading rate, David meets the diagnostic criteria for a learning disability (dyslexia), and he should be allowed extended time (double time, or 100% increase) for any licensing exams that involve prolonged reading. This accommodation includes the upcoming CFA exam.  

On exams that are in a multiple-choice only format, David should be allowed time and one-half (a 50% increase) to complete the exam. Without the extra time, these exams would be measuring his reading rate rather than his subject knowledge. Furthermore, if an exam requires essay-writing, David should not be penalized for spelling errors. Examiners should only evaluate his content knowledge, not his writing skills.  

Recommendations to David

We think it’s important for you to keep building your reading and spelling skills. One good option might be the MindPlay Virtual Reading Coach program. Thirty minutes day, five days a week should be effective in helping you develop phonics skills, improve your spelling, and boost your reading rate. You’ve successfully used so many coping strategies over the years, and we’re optimistic that using an online program like this will provide you with the explicit, systematic instruction you need.  

You may find that you need extra time to complete work-related projects that are reading- or writing-intensive. If that’s the case, consider whether disclosing this diagnosis might be a good idea for you. Dyslexia isn’t something that you need to hide.  

Outcomes

The TOD-C helped us identify dyslexia in an adult patient who, after a lifetime of reading, writing, and spelling difficulties, needed to access accommodations to pass a career-advancing professional test. The TOD-C’s vocabulary and reasoning tests, combined with math tests from the Woodcock-Johnson IV Achievement test, helped us form a complete picture of David’s academic strengths. We were so pleased to be able to help David achieve his career goals and plan for additional learning in the future.  

This case example provides information based on the Tests of Dyslexia (TOD), published by WPS. The original case example appears in Chapter 3 of the TOD Manual.

Related to this TOD Case Example: 

• Dyslexia Characteristics at Different Ages 
• Dyslexia Assessment Tool Kit 
• Introduction to the Tests of Dyslexia (TOD®)

The summary below is based on an actual case example from the TOD authors Nancy Mather, PhD, Sherry Bell, PhD, Steve McCallum, PhD, and Barbara Wendling, MA. We’ve changed the personally identifiable information to protect the privacy of the student and his family.  

Background 

Rebecca is a 7th grade student with long-term difficulties in reading and a family history of dyslexia diagnoses. Held back in Grade 3 out of concern about her reading abilities, Rebecca has worked with tutors in and out of school for several years. Her fluency has improved a little, but she still reads slowly.

Rebecca is a hard worker, coming into school early to take advantage of teacher support sessions and spending extra time and effort to complete her assignments. As a result of her willingness to do the extra work, she has achieved A’s and B’s in school. Still, her parents and her teacher are concerned. They are wondering whether she would benefit from the formal accommodations and supports a dyslexia diagnosis would unlock.

Our Testing Strategy

Rebecca took the online version of the TOD-Screener (TOD®-S) at Homestead Middle. Two of the three tests in the TOD-S, the Letter and Word Choice test, along with the Question Reading Fluency test, gave us her dyslexia risk index (DRI) score: 71. That score is in the Well Below Average range.

By contrast, her score on the Picture Vocabulary test was 115, in the Above Average range, showing that her receptive vocabulary is strong. Rebecca’s DRI, coupled with the discrepancy between her reading ability and her listening ability, cued us to explore more fully with the TOD-C and TOD-C Parent/Caregiver, Teacher, and Self-Rating Scales.

Rebecca’s Assessment Results 

Three weeks after she took the screener, Rebecca completed the TOD-C in two separate sessions. Each session lasted about an hour and a half.   

TOD-C Index Scores 

The tests within the TOD-S and TOD-C produce three distinct index scores:   

• Reading and Spelling Index (measures these two skillsets) 
• Linguistic Processing Index (measures the language skills that underlie reading and spelling) 
• Dyslexia Diagnostic Index (indicates the probability of dyslexia) 

Reading and Spelling Index (RSI) 

Four tests make up the RSI: Letter and Word Choice and Question Reading Fluency (both from the TOD-S), plus Pseudoword Reading and Irregular Word Spelling (from the TOD-C). Rebecca’s standard score on the tests in this index was 74, in the Well Below Average range. 

Linguistic Processing Index (LPI)

Similarly, the LPI is drawn from four tests: Phonological Manipulation, Rapid Letter Naming, Word Pattern Choice, and Word Memory. On these tests, Rebecca’s standard score was 88, in the Below Average range. It’s important to note that her Word Memory score was significantly higher than the other the scores in the LPI.  

Dyslexia Diagnostic Index (DDI)

The DDI is based on the scores of eight tests: two from the TOD-S and the remaining six from the TOD-C. The DDI is an umbrella score that includes both the RSI and LPI. Rebecca’s DDI score was 78, which is in the Well Below Average Range. A DDI score in this range indicates that there is a Very High Probability that Rebecca has dyslexia.  

Composite Scores  

We used additional tests within the TOD-C to help confirm Rebecca’s diagnosis, and to give us more detailed information about exactly which skills most need support.  

Reading and Spelling Composites 

Rebecca’s reading and spelling composite scores come from tests that assess her knowledge and skill in these areas: 

Linguistic Processing Composites 

Rebecca’s language skills showed some variability, which may be owing to the intensive, explicit instruction she’s received in some of these areas.  

Vocabulary and Reasoning Composites  

The Vocabulary and Reasoning composite score is drawn from four tests: Picture Vocabulary, Picture Analogies, Listening Vocabulary, and Geometric Analogies. Together, they yielded a composite score of 125. When we compared this score to her DDI score (78), we noticed a clinically meaningful discrepancy, which does suggest Rebecca has dyslexia.

We also administered the Symbol to Sound Learning test from the TOD-C assessment. It’s a measure that checks Rebecca’s ability to match sounds to symbols that represent letters, blending them to produce real words. These associations were difficult for her—which is unsurprising since it is a characteristic of dyslexia. Rebecca’s score on this measure (87) is considered Below Average.  

TOD-C Teacher, Parent, and Self-Rating Scales

Rebecca’s teacher, Mr. Williams, described her oral language and reasoning abilities as “similar to or better than” those of other students in her grade. He has observed her difficulty with basic reading, orthographic, and spelling skills, and has noticed how slowly she reads compared to her peers. He pointed out, however, that Rebecca reads aloud with great expression and pays attention to punctuation in her writing. Overall, his responses produced a T-score of 67, which shows a High Risk of dyslexia.  

Mrs. Webber, Rebecca’s mom, completed the Parent/Caregiver rating scale. From her view, Rebecca has the most difficulty with reading fluency, even though she enjoys learning. She also noted Rebecca’s difficulty with basic reading, orthographic, and spelling skills. Owing to these difficulties, Rebecca takes a long time to finish any homework assignment that involves reading. Mrs. Webber’s responses produced a T-score of 72, which indicates a Very High Risk of dyslexia.  

Our Diagnostic Impressions 

Using the diagnostic criteria outline in the DSM-5-TR, we have determined that Rebecca has a Specific Learning Disorder with Impairment in Reading (dyslexia). Given her test results, she is eligible for an IEP, 504 plan, or the equivalent.   

Interventions & Recommendations 

After analyzing Rebecca’s performance on the TOD-S and TOD-C and consulting the Dyslexia Interventions and Recommendations: A Companion Guide to the Tests of Dyslexia (TOD), the dyslexia evaluation team feels the following supports would build on Rebecca’s many strengths and help improve her reading abilities: 

1. We recommend that Rebecca’s teachers provide her with extended time on school assignments and tests. These accommodations should be formally outlined in a 504 plan, IEP, or similar document.  
2. Rebecca needs assistive technology to make longer texts and reading materials more accessible. Speech-to-text software should also be provided to help her generate ideas and complete other early-stage processes in writing assignments. Teachers should not penalize Rebecca for spelling errors in her work.  
3. Rebecca needs access to the regular curriculum for students in her grade, but her teachers should be prepared to adjust assignments to accommodate a slower reading rate. For example, if it’s clear Rebecca has mastered a skill or concept, her teachers should shorten her assignments to prevent her from over-working. 
4. Some students with slow reading speed also work extra hard to master math facts. Rebecca may need extra time accommodations for tasks involving math fluency. 
5. Intensive, explicit instruction should focus on reading efficiency and fluency, especially repeated reading strategies to help boost her confidence and skill level.  
6. Rebecca should keep reading for pleasure because it builds her vocabulary, comprehension, and fluency. It’s important to allow her to choose her own reading material.  

Outcomes

Using the TOD-S and TOD-C, Rebecca’s dyslexia evaluation team was able to confirm a diagnosis of dyslexia following years of reading difficulties, intensive instruction, and other interventions. As the academic and organizational demands of middle school increase, it’s particularly important that Rebecca have access to the specialized interventions and supports that an IEP or 504 plan can provide. We now know much more about Rebecca’s many strengths in addition to her areas of need, so we can work with her family to co-create an educational environment that supports and encourages her.  

This case example provides information based on the Tests of Dyslexia (TOD), published by WPS. The original case example appears in Chapter 3 of the TOD Manual. 

Related to this TOD Case Example: 

• Introduction to the Tests of Dyslexia (TOD™) 
• Assessing for Dyslexia in English Learners 
• Dyslexia Assessment Best Practice FAQs 

The summary below is based on an actual case example from the TOD authors Nancy Mather, PhD, Sherry Bell, PhD, Steve McCallum, PhD, and Barbara Wendling, MA. We’ve changed the personally identifiable information to protect the privacy of the student and his family. 

Background 

Jayden Carter is new to Brentfield Elementary. Reviewing his academic record, we learned that Jayden’s grades were low, even though he had extra help in school and at home. Last year, his teacher noted that Jayden would seem to learn a word—only to forget it again. Jayden’s school team recommended testing to explore what’s behind Jayden’s difficulty learning to read.

Jayden’s reading difficulties are in contrast with his overall curiosity, love of telling stories, hearing them, and drawing. He doesn’t seem to have trouble understanding words—it’s more that he misreads them, even simple words. He also gets frustrated and “shuts down” when he is asked to break words down into syllables. Jayden isn’t the only one who feels frustrated. The whole family is at a loss. He isn’t progressing despite nightly help with homework.  

Our Testing Results

Along with all other students in Grades 1-3 at Brentfield Elementary, Jayden took the TOD-Screener (TOD®-S) at the start of the school year. His score on the Picture Vocabulary test was 102, in the Average range for receptive vocabulary. However, on Letter and Word Choice, Jayden scored 70—Well Below Average. On the timed Question Reading Fluency test, his score of 65 showed he is Significantly Below Average. The discrepancy between Jayden’s receptive vocabulary and his reading skills is unexpected. Because the discrepancy indicates a risk of dyslexia, we decided to explore further.

TOD-Comprehensive  

About a week after Jayden took the TOD-S, he took tests 4-9 of the TOD-C. Those tests, combined with two from the TOD-S, yielded three different index scores: the Dyslexia Diagnostic Index (DDI), the Reading and Spelling Index (RSI), and the Linguistic Processes Index (LPI).  Here’s a breakdown of Jayden’s scores on each:  

• DDI: 61 
• RSI: 66 
• LPI: 67 

All three scores are Significantly Below Average. Though the DDI is the most informative diagnostically, all three together indicate an Extremely High probability that Jayden has dyslexia.

We opted to give Jayden 10 additional tests within the TOD-C so we could gather a broad range of data his team could use to plan his instruction, support his diagnosis, and help his teachers and family see the full picture of his strengths and needs. 

Composite Scores 

Here’s a brief synopsis of the information we gleaned from the TOD-C: 

Reading and Spelling Composites 

The reading and spelling composite scores are drawn from tests that assess these skill areas: 

Linguistic Processing Composites 

The linguistic processing composites showed us Jayden’s language abilities, which form the foundation of many reading skills.  

Vocabulary and Reasoning Composites 

Comparing Jayden’s oral language and reasoning scores to scores in the DDI gave us important diagnostic clues. A significant discrepancy between the vocabulary/reasoning abilities and reading skills suggests dyslexia may be the right diagnosis.  

Jayden’s composite score on these two tests was 109, which is in the Average range. The discrepancy is clinically meaningful, again suggesting dyslexia.  

TOD-C Teacher and Parent/Caregiver Rating Scales 

Ms. Amanda Jacobs, Jayden’s 3rd grade teacher, confirmed that his oral language and reasoning are on par with his peers. She has noticed significant reading difficulties, especially with blending, segmenting, reading longer words, reading expressively, and understanding what he reads. Her ratings produced a T-score of 68, which indicates a High Risk of dyslexia.

Jayden’s mom was not aware of any family history of dyslexia, and she reported that he had extra help with reading at his previous school. She has also noticed reading difficulties. He reads slowly, needs extra homework time when reading is involved, and doesn’t seem to read for enjoyment. Like Jayden’s teacher, his mom saw his vocabulary and reasoning ability as strong. Her ratings produced a T-score of 72, which suggests a Very High Risk of dyslexia.  

Our Recommendations

When we reviewed Jayden’s TOD-S and TOD-C performance and considered the information gathered through rating scales and observations, we came to a clinical judgment that a diagnosis of dyslexia (specific learning disability in reading) is appropriate.

Here are the first steps we recommend: 

1. Jayden should be considered eligible for Brentfield Elementary’s dyslexia instructional program. He needs explicit, systematic reading instruction right away. 
2. Jayden also needs instruction and practice in common orthographic spelling patterns. Two good options are Scholastic Spelling and Spellography. It’s important to limit the amount of reading in Jayden’s classwork and to offer him other ways to show what he knows. Project-based learning involving oral presentations, art, and/or math will allow Jayden to use and build skills he has in abundance. 
3. Jayden needs extra time on assignments and tests that require a lot of reading.  
4. Instruction should include helping Jayden learn to read and spell high-frequency words. Possibilities could include Dolch word lists or Fry’s 300 Instant Words.  
5. Audio textbooks will help Jayden stay current with learning in content areas. 

Outcomes

When Jayden’s TOD-S results showed an increased risk for dyslexia, we were able to use the TOD-C tests to dig deeper and determine that he is eligible for a dyslexia diagnosis. That diagnosis unlocked resources that we hope will make a big difference as Jayden progresses through third grade.

In addition to providing clear diagnostic information, TOD-C tests gave us valuable knowledge about Jayden’s strengths and the areas where his team needs to focus instruction. Using the TOD Intervention Guidebook, we were also able to suggest reasonable accommodations, as well as alternative learning options and supports that should lower Jayden’s frustration and steady his motivation as he learns. 

This case example provides information based on the Tests of Dyslexia (TOD), published by WPS. The original case example appears in Chapter 3 of the TOD Manual. 

Related to this TOD Case Example: 

• The WPS Guide to Reading Assessment 
• Dyslexia Characteristics at Different Ages 
• Challenges in Testing for Dyslexia