Advanced Cross-Battery Assessment Using CHC Theory and Neuropsychological Measures

1. Advanced Cross-Battery AssessmentUsing CHC Theory and Neuropsychological Measures Catherine A. Fiorello, Ph.D., ABPP Temple University September 30, 2011

2. Workshop Objectives • Participants will be able to: • Use XBA to detect processing deficits in identifying students with LD and ADHD • Describe how processing assessment can be integrated within an RtI model • Understand how CHC Theory and neuropsychological assessment work together

3. Cognitive Product or Process:Synthesizing Paradigms Nomothetic Assessment Idiographic Assessment • Compares individual to norm • Focuses on score: Assessment Product • Interpret levels of performance • Compares individual to self • Focuses on performance: Assessment Process • Interpret patterns of performance BOTH essential for effective assessment and intervention

4. IDEA 2004: The Impetus for Developing Better Assessment and Intervention Strategies

5. Identifying Children with Learning Disabilities: IDEA Definitions and Practices Defining Learning Disabilities • Learning Disabilities is a disorder of one or more of the basic psychological processes that adversely affects educational achievement in one or more academic domains Determining Learning Disabilities • Discrepancy between “ability” and “achievement” (typically using cut-off points and global IQ) • Failure to respond to scientific research-based intervention • May permit the use of other alternative research-based procedures for determining whether a child has a specific learning disability, as defined in §300.8(c)(10) (OSERS Final Regulations-8/06)

6. RtI as Prereferral Process • Prereferral interventions, with good progress monitoring, are essential to serving children. • Interventions may help a large number of children (e.g., Torgeson, early reading, 94-96%). • Tracking response to intervention provides good information about what works and what doesn't. • Avoids “waiting to fail.”

7. Problems with RtI • Established interventions for many referral problems do not exist. • Agreement on goal setting (what is failure to respond?) can be problematic. • Many children are referred for multiple areas of difficulty. • Failure to respond may be due to many reasons other than disability.

8. RtI and LD • RtI provides valuable information as part of an evaluation for learning disabilities • A failure to respond to interventions is not, by itself, diagnostic of a learning disability. • Cognitive and neuropsychological processing is critical to identifying LD. • School psychologists can and should evaluate processing.

9. Fiorello Comprehensive RTI Model High quality research-based teaching ~85% Universal screening Protocol-based interventions ~10% Individual screening Personalized interventions ~3% Comprehensive assessment: cog/neuro/ach ecobehavioral personality etc. IEP ~2%

10. Implications for Assessment and Intervention Cognitive Hypothesis Testing Model Theory 1. Presenting Problem 5. Cognitive Strengths/Weaknesses 9. Intervention Consultation Interpretation Hypothesis 13. Continue/Terminate/Modify 2.Intellectual/Cognitive Problem 4. Interpret IQ or Demands Analysis 8. Interpret Constructs/Compare 6. Choose Related Construct Test 12. Determine Intervention Efficacy 10. Choose Plausible Intervention Data Collection 3. Administer/Score Intelligence Test 7. Administer/Score Related Construct Test 11. Collect Objective Intervention Data Source: Hale, J. B., & Fiorello, C. A. (2004). School Neuropsychology: A Practitioner’s Handbook. New York, NY: Guilford Press.

11. Processing and LD • Literature in cognition, cognitive assessment, neuropsychology, and learning disabilities links cognitive processing with achievement and LD. • Regular education curricula tend to focus on a few areas of processing (e.g., phonemic awareness) to the exclusion of many others. • Once there has been failure to respond, process assessment can be used to develop interventions.

12. School Neuropsychology: The Key to Reconceptualizng Cognitive Processes for Assessment and Intervention

13. The Two Axes Interpretation Anterior -Executive Functions -Motor Output Posterior -Sensory Input -Comprehension

14. Structural Hemispheric Differences Right Hemisphere Left Hemisphere More Grey Matter More White Matter More Primary Cortex More Association Cortex More Intramodal Connections More Intermodal Connections Source: Goldberg, E., & Costa, L. D. (1981). Hemispheric differences in the acquisition and use of descriptive systems. Brain and Language, 14, 144-173.

15. The Two Axes Interpretation Anterior -Executive Functions -Motor Output Left Hemisphere -Routinized/Detailed/Local -Convergent/Concordant -Crystallized Abilities Right Hemisphere -Novel/Global/Coarse -Divergent/Discordant -Fluid Abilities Posterior -Sensory Input -Comprehension

16. Is There Evidence? • Newborn language processing • Musician processing of symphonies • American Sign Language in the deaf • Brain activation in novice-new learning vs. expert-learned • Bilateral fMRI activation: Left and right for Verbal; Right and left for nonverbal processing Psychological processes matter more than stimulus input or response output! Source: Hale, J. B., & Fiorello, C. A. (2004). School Neuropsychology: A Practitioner’s Handbook. New York, NY: Guilford.

17. Hemispheric Functions and Language Right Hemisphere Left Hemisphere Source Routinized/Automatic Novel/New Learning Goldberg/Costa, 1981 Low Demand High Demand Belger & Banich, 1998 Local/Detailed Global/Holistic Delis et al., 1986 Microstructural Macrostructural Glosser, 1993 Fine Processes Coarse Processes Beeman/Chiarello, 1998 Close Semantic Distant Semantic Chiarello, 1998 Simple Syntax Complex Syntax Cooke et al., 2001 Concordant/ Convergent Discordant/ Divergent Bryan & Hale, 2001

18. Comprehensive Assessment Model HOME SCHOOL Family Constellation Siblings Attachment Parental Mental Health Parental Educational Background Resources Instruction Interventions Structure Supports Services Language History Language Development Background Knowledge Motivation Academic Skills Study Skills Adaptive Behavior STUDENT Developmental Status Physical Health Cognitive Abilities Emotion Regulation Psychopathology Vocational Interests Economic Resources Social Resources Role Models Violence Social Skills Friendship Role Models Bullying COMMUNITY PEERS

19. The Cattell-Horn-Carroll (CHC) Model

20. CHC Model, cont.

21. The Neuropsychology ofReading Disorders Reading Comprehension Word Recognition • Phonological Awareness • Symbolic Representation • Phoneme-Grapheme Correspondence • Timing/Automaticity • Word Attack vs. Sight Word Strategies • Semantics • Syntax • Pragmatics • Timing/Automaticity-Fluency • Explicit-Factual vs. Implicit-Inferential Comprehension Double-Deficit or multiple subtypes? Source: Hale, J. B., & Fiorello, C. A. (2004). School Neuropsychology: A Practitioner’s Handbook. New York, NY: Guilford.

22. The Neuropsychology ofMath Disorders Word Problems Computation • Quantitative Knowledge • Value-Grapheme Correspondence • Sequential/Working Memory • Visual-Perceptual-Spatial (higher only) • Graphomotor • Auditory Processing • Verbal Comprehension • Quantitative Knowledge • Word/Symbolic Representation • Sequential/Working Memory • Fluid/Quantitative Reasoning Source: Hale, J. B., & Fiorello, C. A. (2004). School Neuropsychology: A Practitioner’s Handbook. New York, NY: Guilford.

23. Developing and Testing Hypotheses About Cognitive Processes and Achievement • Examine profile for significant subtest or factor scatter • If global scores are invalid, interpret subtest performance within and between subtests • Use Demands Analysis to examine Input, Processing, and Output Demands • (Caution: Processing Demands More Relevant) • Demands Analysis is prone to error, must validate with additional measures • (Caution: Avoid Cookbook Interpretation) • Data must show convergent, divergent, AND ecological validity

24. Demands Analysis: Block DesignDetermining InputProcessingOutput Demands

25. Demands Analysis: WISC-IV Block DesignDetermining InputProcessingOutput Demands • Input Demands: • Models and abstract visual pictures • Lengthy oral directions-receptive language • Demonstration and modeling • Perception of timed task • Low cultural knowledge and emotional content

26. Demands Analysis: WISC-IV Block DesignDetermining InputProcessingOutput Demands • Processing Demands: • Novel task for most children (note beginning vs. later task performance-also when lines removed) • Visual processing: Spatial-global • Visual processing: Directional orientation-local • Perceptual analysis (divergent thought) and synthesis (convergent thought) • Planning, strategizing, and monitoring performance: Match to sample • Sustain attention, inhibit impulsive/error responding

27. Demands Analysis: WISC-IV Block DesignDetermining InputProcessingOutput Demands • Output Demands: • Fine motor response, arrange manipulatives • Bimanual sensory (visual-somatosensory) – motor coordination • Processing speed

28. Processing AssessmentUsing Specific Tests

29. DAS-II

30. DAS-II, cont.

31. KABC-II

32. KABC-II, cont.

33. CAS

34. CAS, cont.

35. WISC-IV Integrated

36. WISC-IV Integrated, cont.

37. CMS

38. NEPSY-II

39. NEPSY-II, cont.

40. NEPSY-II, cont.

41. NEPSY-II, cont.

42. NEPSY-II, cont.

43. D-KEFS

44. CTOPP

45. CTOPP, cont.

46. Tests Discussed • CMSChildren’s Memory Scale PsychCorp/Pearson • CASCognitive Assessment System Riverside • CTOPPComprehensive Test of Phonological Processing Pro-Ed • DAS-IIDifferential Abilities Scales Second Edition PsychCorp/Pearson • D-KEFSDelis-Kaplan Executive Function System PsychCorp/Pearson • KABC-IIKaufman Assessment Battery for Children Second Edition Pearson Assessments • NEPSY-II PsychCorp/Pearson • WISC-IV Integrated PsychCorp/Pearson