Early Identification: Predicting Reading Disabilities and Dyslexia

  • 15 February, 2019
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Teacher question:

Prevention of dyslexia an other reading problems should be everyone’s number one priority. Why isn’t their more emphasis on the early identification of reading problems, before they have a chance to ruin children’s lives?

Shanahan response:

In 2018. I was asked to edit an issue of Perspectives of Language and Literacy devoted to this issue. Below is the introduction to that issue and at the end I have included a link so you can follow up on any of the other articles in this issue by an impressive array of scholars who know a lot about the early identification of reading problems.

When I was a young teacher, I taught children with reading problems. Teachers would refer some of their students for evaluation, I would give them a test and decide who I could work with. One youngster that I added to my rolls was a first-grader.

I soon found myself chastised by the district school board for this particular decision.

“Why would you give special reading teaching to a 6-year-old?” I was asked.

In 2018, my decision seems more like “business as usual” than the board’s questions might suggest. These days I would have little to explain for providing extra reading tuition to a first-grader. But why was that so unusual 50 years ago?

The ideology around reading in those days held that students who struggled with beginning reading would eventually outgrow the problem. Low maturity was seen not as something that prevented learning—it simply delayed it. Intervening too early would not help, since the student would still be immature (what 6-year-old isn’t?), and my extra instruction might do harm and was certainly a waste of resources.

The idea of preventing—as opposed to remediating—reading difficulties has been around since the 1930s. However, researchers made little headway with the problem for about 30 years.

The earliest study of the issue that I’m aware of is Chester Bennett’s (1938) An Inquiry into the Genesis of Poor Reading. Bennett’s idea of early identification was to look at second- and third-graders to try to figure out their differentiating characteristics. Given that goal, the study was an abject failure. The author looked at a wide range of characteristics… birth order, speech defects, persistence, physicality, attitude toward school, incidents of crying, fear, headaches, and so on. With the exception of the ordinal birth position and, perhaps, speech defects, the whole list of features was as likely to be the results of reading problems as their cause. The author’s conclusion: researchers should go back to an earlier time in the child’s life. Indeed.

Unfortunately, it was a good long time before researchers took him up on the challenge. Oh, there were small investigations here and there showing that speech problems implicated in reading disability could be detected earlier (Hildreth, 1946), or that using more effective instructional procedures in grade 1 could “prevent” reading problems (Dunklin, 1940; Yoakam, 1943). But there was no concerted effort to develop schemes for predicting who was likely to have difficulty in learning to read—or to develop interventions aimed at disrupting these predictions (rendering the sure failures successful). 

That would change with the landmark contributions of Jansky and deHirsch. Katrina deHirsch was the director of the Pediatric Language Disorder Clinic at Columbia-Presbyterian Medical Center from 1941 to 1972 and her colleague Jeannette Jansky was a learning disabilities specialist. Their book, Preventing Reading Failure: Prediction, Diagnosis, Intervention (1972) provided a longitudinal analysis of more than 400 kindergarten children, in an effort to try to identify—prior to the onset of formal teaching—who would likely fail at reading. (An earlier, less ambitious version of the book had been published in 1966.) Their data led them to conclude that the best approach to early identification was a quick screener to pinpoint which children would struggle, and then a more extensive battery of diagnostic tests (covering a wide range of physical, cognitive, and perceptual variables) to explore the patterns of competencies that would guide instruction.

That effort was far from the last word on the subject and today, I think it is fair to say, much of their scheme has been superseded. However, at least partly due to that work, there is now a clear mandate to figure out which children are likely to struggle—and to do so prior to the onset of that struggle. Unless reading problems can be prevented, or addressed successfully very early, there are likely to be damaging secondary problems (the students’ reactions and responses to their failures) that can only complicate eventual remediation.

These days we have many more variables available to us— variables that go well beyond anything Jansky and deHirsch could have hoped for, including genetic screenings and various kinds of brain scans. Nevertheless, we are still confronted by many of the same problems that their work uncovered more than 50 years ago: the multivariate nature of reading difficulty, the complication of poor or inadequate teaching, false-negatives in prediction, and so on.

This issue of Perspectives on Language and Literacy provides a decidedly contemporary perspective on the early identification of reading difficulties. Mads Poulsen, a psycholinguist based in Copenhagen, Denmark, provides a thoughtful analysis of the need for accuracy in any early prediction model. Any scheme sensitive enough to reveal all students who will eventually struggle inevitably will result in “false-positives”— the misclassification of students with no need of extra learning support. And, schemes that minimize such misidentification will necessarily miss some of those in need. Professor Poulsen explains why that is and what is required to optimize early identification efforts so that they will have practical value.

In the 1930s “early identification” meant revealing those who had failed to learn to read after only a year or so of instruction. These days by early we tend to mean kindergarten. But what if it were possible to figure out who was going to suffer from reading disability years earlier than this? Recent advances in brain science suggest that this possibility may be more than a science fiction dream. Ola Ozernov-Palchik and John Gabrieli are neuroscientists who use brain imaging to identify the neural structures and functions that underlie reading development. Their work is pertinent to the issue of prediction of dyslexia because they explore neuroanatomy at a variety of ages, including infancy. Most studies of the neurological correlates of reading are conducted with already-struggling readers. From such studies it is impossible to discern which differences predate the failure to learn. Since learning to read changes the brain, there is a real need for pre-instruction neural exploration.

Then we explore a couple of practical pedagogical issues in the early identification of reading difficulty. David Kilpatrick, a clinical psychologist and author of the influential Essentials of Assessing, Preventing, and Overcoming Reading Difficulties, explores the role of causation in prediction and assessment schemes. His conclusion: once a reading problem emerges it doesn’t matter much what its etiology—since ultimately etiology cannot determine what assessments to use or which instructional interventions will work.

His discussion of the causes of reading problems made me think about the biggest gap in the prediction literature: No matter how incisively we measure those child factors that suggest future failure…such efforts cannot tell us anything about the instructional environment the student will have to learn within and respond to. Linda Siegel is the former Dorothy C. Lam Chair in Special Education and is editor-in-chief of Perspectives. In this issue, she elaborates on this conundrum, providing a case study of early identification and intervention and how it actually can work within the practicalities of a real school.

Finally, Hugh Catts and Yaacov Petscher, experts in the field of learning disabilities (the former a specialist in Speech, Language and Hearing and the latter a psychologist focused on reading), point us toward the future of early identification. They hypothesize that since reading development is undermined by multiple causal deficits, successful early identification schemes will need to be multifactorial in design and they argue for including computer assisted technology, gamification, and longitudinal models in the development of 21st century early identification efforts. This approach may seem to contradict David Kilpatrick’s claims about the current usefulness of causal explanations in the diagnosis and correction of reading difficulties; but remember, Kilpatrick is explaining the current state of the art in the field, while Catts and Petscher are imagining a future when we will surely know more. If they are correct, then it seems likely that early identification in 2030 will be as different from our 2018 concept as our current efforts are from those of the Jansky and deHirsch era.

Buckle your seat belts; it could be a bumpy—but fascinating and rewarding—ride.

Meanwhile, if I were a kindergarten teacher I’d screen my students early in the year to see what they knew about reading…particularly examining their knowledge of letter names and sounds, their phonological awareness, and awareness of print features (the kinds of skills that Kilpatrick describes). My focus would be on knowledge of literacy rather than on underlying causes or correlates. Although Ozernov-Palchik and Gabrieli and Catts and Petscher’s insights are exciting and hopeful, they are not yet user-ready. I’d implement daily lessons aimed at teaching these early literacy skills, monitoring student progress over the first semester. The screening information, although helpful, is not likely to be sufficiently predictive on its own (Poulsen), both because of the imperfections of testing and the variability evident in classroom environments (Siegel). Predictions based on children’s learning success during those early months improve prediction and are sufficiently accurate to allow for the implementation of intensive early interventions aimed at getting such children on track for success. I hope someday that the future research advances heralded in this issue will render my approach hopelessly outdated, but for now it is likely the best we can do.

References

Bennett, C. (1938). An inquiry into the genesis of poor reading. Bureau of Publications, Teachers College, Columbia University.

Dunklin, H. T. (1940). The prevention of failure in first grade reading. Teachers College Contributions to Education, 802, 1–111.

Hildreth, G. (1946). Speech defects and reading disability. The Elementary School Journal, 46, 326–332.

Jansky, J., & deHirsch, K. (1972). Preventing reading failure: Prediction, diagnosis, intervention. New York, NY: Harper & Row.

Yoakam, G. A. (1943). An ounce of prevention in reading difficulties. Journal of Consulting Psychology, 9, 125–131.

https://shanahanonliteracy.com/upload/publications/163/pdf/ed3a5412095be4320e550941575ced4b3682086e.1.pdf

 

 

 

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Early Identification: Predicting Reading Disabilities and Dyslexia

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