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????????Lindsay Whitman???????/???????????????

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I field many questions from parents who are concerned with their child's ability to read. Indeed, there are many confusing pieces of information on the internet that have the potential to mislead parents or teachers in understanding the reasons why one should (or should not) be concerned with a child or adolescent s reading skill development. Other parents ask me to describe the ways that a neuropsychological or psychoeducational evaluation may help their child if indeed a reading difficulty is identified. This piece is intended to define dyslexia and discuss the process and value of a comprehensive evaluation process.

Dyslexia is another term for Reading Disorder, which is the technical term for reading difficulties used in the Diagnostic and Statistical Manual-IV-TR ( DSM : the manual used by psychologists and social workers which lists and describes all possible diagnoses). In order to meet DSM-IV-TR criteria for reading disorder/dyslexia, a child's reading skills must be substantially below what would be expected given her/his age, intelligence level, and education (as noted below, this objective discrepancy is NOT the only nor the most important criterion to consider). In addition, the child's reading difficulty must interfere to a noticeable degree with both his/her academic performance and any general life skills that require reading proficiency. Finally, if the child has a sensory problem (e.g., vision difficulty), his/her reading difficulties must be over and above what would be expected based on the sensory difficulty alone.

There are two types of dyslexia: developmental dyslexia (e.g., an individual is born with difficulties) and acquired dyslexia (e.g., an individual acquires reading difficulties secondary to a sudden occurrence such as a neurological injury). Developmental dyslexia is common among individuals with first-degree relatives with learning disorders. Thus, although dyslexia appears to be highly heritable, a child's environment (e.g., how much the child's parents encourage or model reading behaviors, how many books or reading materials are in the home) also seems to play an important role in the development of different types of reading profiles (Haiyou-Thomas, 2008).

Recent research shows that there are clear functional differences in the brain systems of children and young adults diagnosed with developmental dyslexia (Richlan, Kronbichler, & Wimmer, 2011). Research has also demonstrated that the functionality of disrupted brain systems has the potential to change upon exposure to high quality reading remediation (Shaywitz, Lyon, & Shaywitz, 2006). In other words, research suggests that with proper and timely reading intervention, the brains of children with dyslexia can change to function more similarly to the brains of children without dyslexia. This suggests that it is very important to identify early vulnerabilities to reading difficulties in children so that high quality programming may be initiated as soon as possible. In general, a younger child's brain is more plastic or malleable than an older child's brain, and thus, there is greater potential for more efficient change in younger children. (Identification of reading vulnerabilities before age six or seven is ideal.)

如果我担心自己的孩子,神经心理学家应该进行什么样的评估来评估我的孩子是否符合阅读障碍的标准

当转介孩子进行神经心理学或心理教育评估时,除了阅读外,通常还会提及其他一些问题(例如注意力/专心,数学技能,手写,冲动/行为,情绪,社交技能)。因此,应始终针对每个孩子进行评估。但是,在任何评估中,都有三部分被诊断为必不可少的阅读障碍/阅读障碍。

1.解码和/或阅读理解测试的标准分数必须明显低于其年龄和/或受教育程度的其他儿童,才能诊断阅读障碍。重要的是,被比较的孩子要接受相同的教育水平(例如,如果一个孩子病了很多年并且缺课很多,直接比较他/他可能并不完全合适)到他的同龄同龄人群中)。

2.为了诊断诵读困难,必须有大量证据(通过病史,临床观察和各种测验的评分方式)来确定该儿童的阅读困难程度(例如,这个孩子的语言非常好,词汇量很好,并且显示出较强的学业,思维能力或语言能力。

3. Although recent research indicates that there may be different subtypes of dyslexia which include or do not include phonologic weakness (O Brien, Wolf, & Lovett, 2011), the traditional understanding of dyslexia includes this clinical feature (e.g., clear and consistent difficulty linking sounds to letters). Thus, a thorough evaluation of dyslexia must thoroughly investigate the presence/absence of this quality in a child's reading skill set via standardized tests of decoding. Other aspects of a child's developing reading skills such as oral reading fluency, spelling skills, and reading comprehension are also central to an evaluation of dyslexia.

It is common for schools to rely heavily on the essence of criteria one or a discrepancy model (i.e., a 15-standard score point gap between a child's intelligence level and reading level) to identify reading difficulties in children. This is concerning not only because there are important variations among testing materials between schools, but also because this approach does not necessarily capture the presence or absence of the phonologic component of dyslexia. Elimination of this component of an evaluation compromises accurate identification of children with these difficulties and the provision of a clear description of specific learning needs (e.g., type of intervention program, intensity of intervention format), leading to the possibility that a child will be matched with a reading program does not address his/her needs. Pairing a child with the wrong type of services may lead to what seems to be a lack of success when the true reason for difficulty is that his/her needs are not being appropriately supported.

因此,总而言之,如果我担心自己的孩子,为什么真正全面的神经心理学/心理教育评估过程很重要

如上所述,尽早识别儿童的阅读困难非常重要。为孩子提供适当类型的支持服务的时间越早,进行补救的迅速进展的机会就越大。此外,有许多教室/学校住宿设施可以并应提供给阅读困难的孩子,这将在学业上为他们提供支持,并有望减轻他们的过度焦虑或压力。为阅读障碍儿童提供住宿的例子可能包括(当然取决于孩子)延长的课时和标准化考试时间,安静的空间来完成工作,提供有声读物或记笔记服务以及使用基于视觉的学习方法助手总而言之,神经心理学评估不仅会在非常全面(从而可能更准确)的水平上确定您孩子的需求,而且还会提供直接(例如课堂)或同等重要的间接(例如, ,以增强自尊或减轻焦虑的治疗支持)推荐的服务,以在他们的学习过程中为他或她提供最佳支持。

如果您对孩子有疑问,或者对孩子可能需要进行神经心理学或心理教育评估有疑问,请随时致电347-560-1399与我联系,进行30分钟的免费咨询。也可以通过lindsaywhitmanphd@gmail.com向我发送电子邮件。

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Hayiou-Thomas,ME(2008)。遗传和环境对早期言语,语言和读写能力发展的影响。通讯障碍杂志,41(5),397-408。

O Brien,B.,Wolf,M.和Lovett,M.(2011)。诵读困难亚型的分类法研究。阅读障碍,18(1),16-39。

Richlan,F.,Kronbichler,M.和Wimmer,H.(2011)。荟萃分析阅读障碍儿童的脑功能障碍。神经影像,56(3),1735-1742。

Shaywitz,BA,Lyon,GR&Shaywitz,SE(2006)。磁共振成像在理解阅读和阅读障碍中的作用。发育神经心理学,30(1),613-632。

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