Treat the Need not the Label

Every few months a newspaper report comes along to claim ‘dyslexia doesn’t exist’ or ‘ADHD is made up’. Of course, this is usually a sensationalist version of a new report showing controversial research in the field. Yesterday, Tom Bennett wrote an article on the misdiagnosis of ADHD and dyslexia.

https://www.tes.com/news/school-new…r-dyslexia-and-adhd-are-over-diagnosed-crypto

For a SENDCo this can become tricky as teachers may begin questioning your advice citing this example from a ‘behaviour tsar’ as evidence. They would be right to question you, after all Bennett influences government policy, he must know what he’s talking about, right? This is my response.

It is perfectly valid to question the validity of diagnoses such as ADHD and dyslexia. There has been an increase in children with ADHD and medication such as Ritalin is being prescribed more. There are correlations with government policy (in US) and it is sad if normal behaviour is being pathologized. In contrast, figures for diagnoses of dyslexia in state schools is going down which appears to correlate with the reduction in Local Authority SENSS services. Dorset for instance, which still has a service has more dyslexia recorded than other counties who no longer have a service. You could, I’m sure find a similar picture in the quality of NHS services when assessing for ADHD. It’s complex, and it’s not perfect. 

But none of this should matter to the day to day practice in a mainstream, classroom. What would a teacher do differently if a child was diagnosed with ADHD compared to one who wasn’t?
As teachers we have no right to question a paediatrician even if we want to. We have no right telling a parent that we believe their child doesn’t have ADHD because a ‘behaviour guru’ told us that misdiagnosis is rife. We have no right to tell another teacher that if they just set some boundaries that the ADHD is likely to disappear. We have no right, morally or, as it happens, legally. 

We have no right telling a 15 year old who can’t read that the diagnosis of dyslexia isn’t true because it doesn’t exist. The Equality Act and the teaching standards mean that as a classroom teacher we must put reasonable adjustments in place to meet the needs of all our students, not just the typically developing ones.

This may seem harsh but it’s true. What we do have control over however is the classroom, our students, and their right to learn. We have the right to expect support from the leadership team, our SENDCo and outside agencies should we need it. All our children have the right to an education and we have the right to deliver it in whatever way we wish as long as we are meeting the needs of the class.

A professional teacher must be informed, know their students well and teach responsively. Where does the label come in? Well, only as a starting point. It’s part of an holistic picture of the child. It doesn’t matter if the child has ADHD or not. If she is exhibiting behaviour traits which seem similar them treat the need not the label. A child with ADHD is impulsive, struggles to filter out irrelevant information and can become easily overwhelmed. This is really useful information.

Let me give you an example of responsive teaching based on this. A child comes bouncing in from the playground. She’s been playing a game of ‘wee and poo’ with her friends. Not under adult supervision the children have been shouting wee and poo at each other and giggling. The bell goes; her typical friends find it easy to transition back into the classroom and ‘turn off’ the game, walking quietly into class, sitting themselves down and preparing for learning. The girl with ADHD however struggles to self-regulate; she’s still mentally in the game and runs into class blurting out ‘poo’. She’s immediately in trouble and is sent to sit away from the group. Becoming upset, the pupil screams at the TA who is trying to keep her away from the group and the incident escalates until she’s sent out of the classroom to prevent disruption to the rest of the class.

As a teacher, observing behaviour traits which appear similar to those of ADHD, I can anticipate this impulsivity. Putting my hand up to the little girl as a physical reminder to self-regulate. I then tell her playtime is over and it’s time for learning. She’s given a few minutes for the transition to ‘check in’ then I ask her to enter the classroom calmly for learning. 

It doesn’t matter if this child has an official diagnosis of ADHD or not, recognising behaviour traits and responding is the same, label or no label.

 

No Excuses

When I watch those videos from the No Excuses schools in the US, I am scanning the room for the type of children I teach. The ones that have sensory difficulties; that really isn’t an excuse.  In fact it’s probably one of the most research heavy areas there is in SEND.

I see the ones who look slightly bewildered; that’s not an excuse either. The pace of some of the teachers’ chorusing would not be helping those with slow processing and/or language learning impairments. 

And I see the eye tracking thing.  Eye contact is very difficult for some students with autism (also not an excuse) and I often ask teachers who say a child is never listening whether they’ve checked by asking them. Some students (often with ADHD in my experience) might be concentrating when they are not looking at the teacher. Others are really listening while playing with Lego or fiddling with play doh. In fact,sometimes I think that when you ask a child to look at the teacher it might be when she is listening the least: have they noticed the mole on an eyebrow? Are they looking at the detail of a patterned shirt?

And then I see the students who are not following the words to the songs, and the chants and the recitals because they can’t remember the words; they are pretending by moving their mouths but they’re out of sync with the rest. These are the ones that are just about coping. I wonder however about the ones who have walked out, sworn at the teachers, won’t sit still, won’t keep quiet, I wonder about them – where are they? They exist, I know they do.  

What makes it better for children who struggle is a differentiated curriculum, an understanding of their needs, strategies to recognise why they blow and places to go when they do. Reasonable adjustments are not excuses.  

We don’t call it dyslexia anymore

Teacher 1: It’s a shame about John; he will get excluded soon.

Teacher2: Why what’s up?

Teacher: I don’t know, he seems fine when you speak to him but he can barely read and write. 

Teacher 2: Does he have dyslexia?

Teacher 1: We don’t use that term anymore, it’s unscientific -dyslexia doesn’t exist. We call it dysteachia.

Teacher2: So you haven’t taught him properly?

Teacher 1: Well not me, he came to us with very poor skills now he just won’t engage in our lessons. 

Teacher 2: But his friends can read and write? So the teaching can’t have been that bad? Surely John is confused why he can’t read and write when his typically developing peers can? Do you tell him he’s got dysteachia? 

Teacher 1: No we tell him he’s got a severe reading difficulty.

Teacher 1: Like dyslexia?

Teacher 2: Well last year he would have had dyslexia but it doesn’t exist, it’s unscientific …

Teacher 1: So now you say severe reading difficulty?

Teacher 2: Yes which wouldn’t have been so severe if he’d been taught properly.

Teacher 1: Right – I thought dyslexia, sorry, severe reading difficulty or is it dysteachia? Anyway, whatever you call it, was when a reading difficulty persists despite interventions?

Teacher 2:  *Shrugs* He doesn’t get on with most of the class. The others tend to spend time in the nurture group, come here for lunchtimes and enjoy the quiet little class we have. 

Teacher 1: Where’s John at break and lunchtime?

Teacher 1: Well he’s outside with his friends – they’re all much brighter than him though – yet you wouldn’t know that to talk to them all – John’s got excellent language skills.

Teacher 2: There’s a discrepancy between his reading and verbal ability?

Teacher 1: But you can’t diagnose dyslexia using the discrepancy model – dyslexia (even though it doesn’t exist) affects all abilities.

Teacher 2: Well it’s not diagnosed purely on a discrepancy model but that can be one factor and dyslexia may well explain why he can’t read and write.

Teacher 1: Well he’s actually weaker than the rest of the group with his reading and writing despite his verbal ability -he’s the worst and needs to learn to read and write.

Teacher 2: But he’s not learning anything because of his behaviour. Do you think John would be better in mainstream English?

Teacher 1: How can he? His reading and writing is like a 6 yr old.

Teacher 2: Well you say he has good language skills, could he not use audio books? Text-to-Speech? Speech recognition?

Teacher 1: He needs to learn to read and write.

Teacher 2: Yes but that could be in a daily 1:1 session;  using a systematic and cumulative reading programme. How is he accessing text and recording his work in the meantime? 

Teacher 1: He’s not, he just plays up, gets sent out of classes and as I said, will be excluded soon. 

Teacher 2: Right.

‘The Challenges of learning to read and write in English’ – notes from Dr Powell’s keynote

Dr Daisy Powell of Reading University gave this talk at Imperial College last Saturday.

I can’t hope to cover all Dr Powell’s keynote but will attempt to summarise the salient points (I have omitted the writing research which I’d like to cover at a later date – but let’s just say it’s linked to reading and there aren’t enough studies).

Opaque/transparent languages

Dr Powell first reminded us how difficult the opaque English language is compared with more transparent languages such as Italian. This means we have an inconsistent relationship between graphemes (letters, or groups of letters) and phonemes (sounds that make up spoken words).

English is still an alphabetic language however so teaching children how to map phonemes to graphemes will allow them to read and spell. There is strong evidence that fostering these decoding skills is effective for early literacy. (Bradley & Bryant 1983, Hatcher et al, 2006)

Causes of Reading Difficulties

Since The Rose Report (2009) reading difficulties have been predominantly linked to a phonological deficit and ‘visual processing has been broadly ignored in research’. Dr Powell however has been researching reading difficulties using a particular visual element called Rapid Automized Naming (RAN).

Denckla and Rudel (1974, 1976) first showed that the fluency with which children can name familiar items is strongly related to reading. This is called RAN and is now a common test used in reading difficulty assessments due to strong RAN-reading links (RAN is tested used a standardised test involving children naming objects, colours, digits or letters at speed).

There are three main profiles then for reading difficulties:

• Phonological deficit
• RAN deficit
• Or RAN-phonology deficit (known as the Double Deficit theory) – this is the least common but causes the most severe reading difficulties        (Wolf, Bowers and Biddle, 2000)

A randomised control trial was set up using a norm group (no deficits), then three other groups using the phonological, RAN and double deficit profiles (Powell, Stainthorp and Stuart 2007).

Initial findings were consistent with the double deficit account of dyslexia; that those with both poor phonological awareness and RAN had the most severe reading difficulties and those with a single deficit had a more moderate reading problem. The low RAN group were however significantly worse at both reading and spelling than the control.

Children with a RAN deficit also performed more poorly than a control group on low level visual processing tasks (Stainthorp et al, 2011).

There are children then who do have reading and spelling difficulties which are not linked to a phonological deficit. This raises the question about the type of intervention given to children with poor RAN.

Policy on Phonics

To try and identify children with poor letter sound correspondence, the government has introduced a screener known as the Phonics Screening Check (PSC) in Year 1. The PSC comprises 40 real words (e.g.‘shut’) and non-real words (e.g.‘jound’) and the pass mark usually sits around 32.

An interim study looked at younger children with intensive phonics teaching (post phonics check) and found exception words (irregular) were significantly harder to read than regular words or non-words whereas older, pre-phonic check children could read irregular words, regular words and non-words equally successfully (Powell, Atkinson & Stainthorp 2014).

Those students who do not have a phonological difficulty but a RAN deficit are currently receiving a phonics rich environment but what they may require, are opportunities to memorise irregular words and receive lots of exposure to print. The possibility also arises that for those with RAN difficulties who have little print exposure in the home environment, could be doubly disadvantaged.

Interestingly children with poor RAN showed better performance on a visual memory task than the control group. This may also point to requiring alternative strategies other than phonics. There is still a chicken or egg question here: are strengths in visual memory and comprehension a cause or consequence of deficits in RAN? Early perceptual difficulties could lead children to adopt strategies other than alphabetic decoding (e.g. relying on visual memory/semantics).

Is phonics all you need?

Some questions which need answering:

• What about words with inconsistent spellings (50% of early vocabulary).
• What about children whose reading difficulties make alphabetic decoding very difficult?

There are also teacher concerns that such an emphasis on phonics, led by the statutory phonics check, may be leading to laborious and dis-fluent (or dysfluent?) reading in some children.

The home literacy environment

Dr Powell said there was a clear link between children’s reading experience in and out of school and their progress learning to read.

Cunningham and Stanovich (1991) developed a checklist which measures exposure to print using an Author/title recognition task – this was asking children to recognise familiar story books.

‘Exposure to print accounted for unique variance in reading over and above IQ and phonological processing skills’.

Similar results were found by Sénéchal and LeFavre’s (2002) home literacy model. This showed better oral language and early literacy for children with positive home reading habits.

What might be relevant for schools?

In conclusion then, there is little doubt that phonics is the best way to foster decoding skills, but in a very rich phonics environment, students may be finding irregular words more challenging to read and spell. There might be a need to memorise irregular words and have opportunities to be exposed to inconsistent spellings through exposure to print. Phonics rich teaching could come at a cost to those students with RAN difficulties who also lack print exposure in the home environment. (Dr Powell did say longitudinal data was necessary to confirm this).

Impact on Literacy

Predictors of reading are print exposure, vocabulary and home literacy environment. In addition, the precursor to reading is oral language (Snowling 2014). Writing skills come from good reading skills and habits.

I would also add that comprehension is an ongoing concern when teaching reading and a rich language environment in the classroom is vital for early literacy alongside phonics and print exposure.

 Thank you for Dr Daisy Powell who gave us such an insightful keynote at the Patoss Conference last week; I hope I haven’t misquoted her or plagiarised or stated speculation as fact or done anything else awful.

Thanks also to Patoss for a great day at Imperial College. 

Day 23 – Popplet for Alternative Assessments #28daysofwriting Assistive Technology

I mention alternative assessments a lot.

But and it’s a big but (I like big buts and I cannot lie) because there are so many tests and exams embedded into the year nowadays, it is harder for teachers to trust in using a different method which does not fit in with SATs tests and the like. I don’t blame you – for if we are pushing for students to pass tests or emerge as a levelled writer or reader, then by using assessments which do not tally with national guidance appears counter intuitive (the new buzz word).

But, what if these alternative assessments did help the end product? What if, by helping the student think through a process in a way which suited them better, it would eventually lead to a higher level in SATs or GCSEs?

Are there students in your class who are writing content which does not warrant the level you know they are capable of? Are there some students who are not writing at all? Are there students who, as soon as you ask them to write, will play up enough to be sent out?

If you have any students who are not achieving for whatever reason, an alternative assessment may be worth thinking about – just occasionally.

Popplet might be the answer (the lite version is free), it’s the simplest to use spider diagram app I have found (I write about concept mapping in Day 6 using Inspiration – for higher order skills this may be better as it turns the map into a linear format – there is a free version on the iPad which is worth looking at).

In Popplet, you can add text, handwriting, photos, images and change colours. It is so simple to use and my favourite thing? Each new box is called a Popple – how cute is that? OK, I am a stationary geek and this is very similar – you may not be feeling my enthusiasm.

It is worth thinking about Popplet for various alternative assessments:

A series of images instead of writing out a sequence.

Hand in work in planning stage instead of writing an essay.

Group work – using Popplet to plan in pairs or in a group but then allow the student who struggles to use and expand the Popplet (with more Popples) while the other students begin to write.

Teaching staff create a Popplet with images which the student then has to add text to.

If having to analyse a magazine article – let student use a Popplet to answer the questions rather than writing full paragraphs (they could then choose one Popple to write a paragraph about).

Talk through an essay question and the member of staff types in the Popplet to reinforce the discussion – then gives to the student as a writing frame. This may prevent the writing inertia stage some students experience.

Other alternative assessments include:

Video answers – Vlogging even?

A news report – using something like ‘I can Present’ which allows text alongside the video.

Twitter exchanges

Storyboarding – asking the student to plan the story and then write one paragraph from a picture – the overview is there to talk through.

In Romeo and Juliet – students have been asked to write about the Prologue using quotations. Ask student to produce tableaus with quotations instead. Could even be created using modelling clay or Lego?

What do you want from the student at this point in time? (not for SATs or GCSEs – end product) If it is to show understanding, then can they use an alternative assessment?

Clearly they need to practise for tests and exams – but small steps? By using Popplet with just one really good paragraph of writing may be the first step to something of better quality later. Using David Didau’s (@Learningspy) ‘Slow Writing’ could be the next step on from Popplet perhaps?

Do you have any other ideas for alternative assessments? I would love to hear about them.

Day 17 – the Exam Pen in an upside down video #28daysofwriting

So far I have concentrated on students who have poor skills – in exam arrangement speak this means those eligible for readers and scribes (standardised score of 85 or a range of scores between 85-90).

But what about those students who are ‘a little bit weak’ reading? They can read quite well and relatively fluently but comprehension is blighted by the odd multisyllabic word they don’t recognise. In class, they can ask but they are on their own in exams. The few words the student cannot read may mean a misreading of the content or misinterpretation of the question.

For these students, an exam pen could be the answer. The pen scans a word and reads it – the student can stay in the hall because the pen can be used with a set of earphones. This exam pen is allowed in exams as there is no dictionary in the pen – and the JCQ has agreed anyone can use one.

These pens are ridiculousy expensive (£190) which is a shame (and possibly unneccesary for what they are) but it may be worth considering for certain students.

Here is a video showing how the exam pen works – I did it very quickly for @aspiedelazouch a few months ago and it’s upside down – sorry. I would have done it again for you but my exam pen is at home and I am at my lovely Mum’s being spoiled – half term woes.

I’d be interested to hear any feedback on these pens – one secondary school I visited recently told me one girl used one in all her classes and it has transformed her attitude and improved her reading.

Day 14 – Assistive Technology – VoiceDream – #28daysofwriting

Wow, we’re half way through. When I started this I wasn’t really sure if I’d make the 28 days but I’m feeling more confident now.

It’s a real discipline to write everyday and I’ve enjoyed it.

I have had a brilliant response from people for the assistive technology series – thanks to all those who have chatted, retweeted and encouraged me.

I love the collaborative nature of @staffrm – it feels positive; sharing and caring. Ah stop me I’m becoming sentimental but really, this is why I’m in teaching and why I love education.

Back to the iPad and VoiceDream.

Yesterday I looked at in-built accessibility for the iPad (Day 13) and I have covered free electronic copies of your class text books from Load2Learn (Day 8).

VoiceDream is an advanced reader – £6.99 on app store.

http://www.voicedream.com

It will read any text – you can open PDFs and docs within the application and it has a browser function too.

You can use a variety of colours to highlight background page, the row, the word before it’s read and the word after it’s read.

A great feature is Original layout and Text layout – the images below show the doc in the two formats by just a tap of the screen.

There are various voices and you can change the speed.

Something which is hugely important for some students is blanking out the text so only a small part is visible. VoiceDream gives you the choice of 5 lines, 3 lines or 1. (Lines Visible)

The first image show 1 line highlighted with widened character spacing.

Character spacing may be important for your poor readers – there is some tentative research showing that character spacing (not just size of text) can help.

There are many other features; translation, autoscroll and it’s easy to use.

I would definitely recommend this text to speech app- it’s thorough, has been carefully thought about and built with love I think.

Appropriate on Valentine’s Day.