Reading and Reading Disabilities for Optometrists

1. Reading and Reading Disabilities for Optometrists Ralph P. Garzia, O.D. College of Optometry UM- St. Louis

2. Definition of Reading Reading is the process of constructing meaning through the dynamic interaction among the reader's existing knowledge, the information suggested by the text and the context of the reading situation

3. Components of Reading (decoding printed words into meaningful, spoken words

4. Reading disabilities - general facts Of the students with specific learning disabilities receiving special education services, 70-80% have deficits in reading. RD affects males and females nearly equally, and people from different ethnic and socio-economic backgrounds as well. 74% of the children who are poor readers in 3rd grade remain poor readers in the 9th grade. Often they can't read well as adults either.

5. Children 3 to 21 years old served in federally supported programs for the disabled, by type of disability: Selected years, 1976-77 through 2005-06

6. The Workforce Investment Act of 1998 defines literacy as 'an individual's ability to read, write, speak in English, compute and solve problems… • …at levels of proficiency necessary to function on the job, in the family of the individual and in society” • As information and technology have increasingly shaped our society, the skills we need to function successfully have gone beyond reading, and literacy has come to include the critical and effective use of these in peoples' lives.

7. Literacy Notes • Children who have not already developed some basic literacy practices when they enter school are three to four times more likely to drop out in later years • 60% of kindergartners in neighborhoods where children did poorly in school did not own a single book • A typical middle class child enters first grade with approximately 1,000 hours of being read to, while a child from a low-income family averages just 25 of those hours

8. Literacy and Corrections • 50% of all adults in federal and state correctional institutions cannot read or write at all. • Only about 33% of those in prison have completed high school. • 7 in 10 prisoners perform at the lowest literacy skill levels

9. Workforce Literacy • About 20 percent of America's workers have low basic skills, and 75 percent of unemployed adults have reading or writing difficulties. • Workers who lack a high school diploma earn a mean monthly income of $452, compared to $1,829 for those with a bachelor's degree. • Employers say: • 32.4% poor reading/writing skills • 26.2% inadequate math skills • 25.0% an inability to communicate

10. Literacy and Health • Individuals with low literacy skills are at risk of not being able to understand materials distributed by health care providers.

11. Most Basic Subdivisions of Reading Word Recognition Comprehension

12. Subdivision I: Word Recognition The process of determining the pronunciation and the meaning of a word in written or printed form The quick and easy identification of the word form, pronunciation, and appropriate meaning of a word previously encountered in print or writing

13. Subdivision II: Reading Comprehension Comprehension is a complex process that has been explained in many ways, such as the following: Comprehension is intentional thinking during which meaning is constructed through interactions between text and reader Comprehension is the process of simultaneously extracting and constructing meaning through interaction and involvement with written language Comprehension is a process in which readers construct meaning by interacting with text through the combination of prior knowledge and previous experience, information in the text, and the stance the reader takes in relationship to the text If readers can read the words but do not understand what they are reading, they are not really reading

14. Fluency What is fluency? Fluency is reading quickly, accurately, and with expression Fluency provides a bridge between word recognition and comprehension

15. Components of fluency automaticity - accuracy of word recognition rate - speed prosody - phrasing expression - intonation and stress on syllables and words All four components must be present for fluent reading. The majority of readers who have reading difficulties lack one or more components of fluency

16. Automaticity Automatic means without any conscious effort or thought Automaticity is the ability to identify words rapidly so that the reader’s attention can be directed toward comprehension. When reading, the non-automatic function is constructing meaning; therefore, when the reader must stop to identify an unknown word, meaning is interrupted Readers MUST identify words accurately and automatically in order to be able to comprehend

17. Rate Reading rate is the speed at which one reads text. Reading rate is usually measured as the number of words read per minute (words per minute or WPM) Readers who have a slow reading rate focus too much on sounding out words. They take long pauses before unknown words and are confused by new vocabulary. They are not aware of syntax or phrasing. They often ignore punctuation and it is difficult to keep track of ideas developed in the passage A slow reading rate affects the amount of reading that can be accomplished

18. Prosody Prosody is the ability to read a text orally using appropriate pitch, stress, and juncture; to project the natural intonation and phrasing of speech upon the written text

19. Expression A meaningful manner of reading/speaking Some children read accurately, but continue to read word-by-word because they do not break text into proper phrases (prosody) or use expression as they read. As a result, comprehension breaks down. When readers embed appropriate volume, tone, emphasis, phrasing, and other elements in oral expression, they are giving evidence of active interpreting or constructing meaning from the passage

20. An example James Earl Jones reads “The Raven”

21. Reading Disabled Child

22. Fluent readers vs. non-fluent readers

23. Fluency and visual stress

24. Reading and visual stress

25. Basic types of reading problems encountered in practice faulty word identification and recognition inappropriate directional attack (i.e. left-to-right) deficiencies in basic comprehension abilities deficiencies in rate of reading with comprehension (fluency)

26. Types of Reading Problems 1. faulty word identification and recognition ineffectual visual analysis of words (i.e. can't use visual perceptual information processing skills (e.g. discrimination) to immediately visually identify a word) insufficient sight word vocabulary (i.e. the immediate recognition of word) limited knowledge of phonics (i.e. can't decode words by using phonics) when a new word is encountered phonetic analysis is used to assist with pronunciation and identification of the word e.g. prolegomenon (scholarly preface or introduction to a book)

27. Types of Reading Problems 2. inappropriate directional attack (i.e. left-to-right) orientational confusion with words (e.g. bad, dad); also includes letter reversals word transpositions (i.e. reading words in the wrong order) faulty eye movements (i.e. making backward or right-to-left movements)

28. Types of Reading Problems 3. deficiencies in basic comprehension abilities limited word meaning awareness (i.e. semantics: doesn't know the meaning of words; therefore, comprehension can suffer) lack of paragraph organization (i.e. unable to develop an understanding of what is read in paragraph sized units) limited ability to evaluate or interpret what is read (i.e. bringing experience and background to the reading activity)

29. Types of Reading Problems 4. deficiencies in rate of reading with comprehension (fluency)  insufficient sight word vocabulary (word identification) over-analytical reading (i.e. reads word-by-word; try to decode every word phonetically not using the faster visual processing approach) insufficient use of context cues (i.e. can't apply previous knowledge or background to the subject matter being read)

30. Reading Failure Cycle

31. Dyslexia Dyslexia is one of several distinct learning disabilities. It is a specific language-based disorder of constitutional origin characterized by difficulties in single word decoding, usually reflecting insufficient phonological processing abilities. These difficulties in single word decoding are often unexpected in relation to age and other cognitive and academic abilities; they are not the result of generalized developmental disability or sensory impairment. Dyslexia is manifest by variable difficulty with different forms of language, often including, in addition to problems reading, a conspicuous problem with acquiring proficiency in writing and spelling. The Definition of Dyslexia as adopted by the Research Committee of International Dyslexia Association, May 11, 1994 and by the National Institutes of Health, 1994.

32. Dyslexia Signs to look for

33. Dyslexia Reid Lyon

34. Presumptive “dyslexia”-characteristics Makes consistent reading and spelling errors such as: *Letter reversals - "d" for "b" as in: "dog" for "bog" *Word reversals - "tip" for "pit" *Inversions - "m" for "w," "u" for "n" *Transpositions - "felt" for "left” or “soiled” for “solid” *Substitutions - "house" for "home” *May confuse small words - "at" for "to," "said" for "and," "does" for "goes” *May transpose number sequences and confuse arithmetic signs (+-x=) *May have poor "fine motor" coordination * Considered “vision” problems and intervention from optometry required

35. Learning to Read first definition = learning to pronounce words second definition = learning to identify words and get their meaning third definition = learning to bring meaning to a text in order to get meaning from that text

36. Reading Readiness the point at which a person is ready to learn to read or the readiness to profit from beginning reading instruction skills that help prepare learners for the task of reading dependent on previous experience with and exposure to reading. the time during which a person transitions from being a non-reader into a reader. other terms include early literacy and emergent reading.

37. Reading Readiness-Key Predictors Understanding the relationship between letters and sounds Knowing the alphabet Ability to write his or her name The size of a child’s vocabulary Expressive language skills Literacy rich dramatic play Reading aloud to children Interactive reading with children in small groups is a strong predictor of a child’s vocabulary

38. Reading development Stages of reading development Jeanne Chall Stage 0 Prereading Oral language development Stage 1 Initial Reading Letters represent sounds Sound-spelling relationships Stage 2 Confirmation and Fluency Decoding skills Fluency Stage 3 Reading for Learning “the New” Expand vocabularies Build background and world knowledge Develop strategic habits Stage 4 Multiple Viewpoints Analyze texts critically Understand multiple points of view Stage 5 Construction and Reconstruction Construct understanding based on analysis and synthesis

39. Stages of reading Stages of reading development From the optometric perspective

40. Joint Statement Joint policy statement on vision, reading and dyslexia

41. Missouri Assessment Program (MAP) MAP 3rd and 4th grade example MAP 6th and 7th grade example

42. Show Me Standards-Communication Arts speaking and writing standard English (including grammar, usage, punctuation, spelling, capitalization) reading and evaluating fiction, poetry and drama reading and evaluating nonfiction works and material (such as biographies, newspapers, technical manuals) writing formally (such as reports, narratives, essays) and informally (such as outlines, notes) comprehending and evaluating the content and artistic aspects of oral and visual presentations (such as story-telling, debates, lectures, multi-media productions) participating in formal and informal presentations and discussions of issues and ideas identifying and evaluating relationships between language and culture

43. Third Grade-Reading Below Basic- locate information in text; identify an obvious main idea; define simple words and phrases. Basic- make simple comparisons; recall simple sequence of events; make obvious inferences and predictions; use context clues to determine word meaning. Proficient- locate/identify supporting details, obvious cause and effect; make inferences; use context clues to determine word meaning; make comparisons; recall detailed sequence of events; identify solutions and fact vs. fiction; recognize figurative language; draw obvious conclusions. Advanced- identify relevant/supporting information to make predictions and draw conclusions; infer word meaning; infer main idea; make complex comparisons; make complex inferences; categorize information; identify correct sequence of events.

44. 2007 MAP Results – Grade 3

45. 2007 MAP Results – Grade 4

46. 2007 MAP Results – Grade 5

47. 2007 MAP Results – Grade 8

48. 2007 MAP Results – Grade 11

49. At risk children During the kindergarten year, for children at risk: the gap in basic reading skills closes e.g. recognizing letters the gap in more difficult tasks widens e.g. reading single words

50. Literacy rich home environment More proficient in reading at the end of kindergarten and 1st grade Children who are: read to sung to told stories to Homes with: Children’s books Records/audiotapes/CDs