How to Identify Neuropsychological Processing Deficits in Children with SLD Milton J. Dehn, Ed.D.,...

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How to Identify Neuropsychological Processing Deficits in Children with SLD Milton J. Dehn, Ed.D., NCSP Schoolhouse Educational Services June 2014

Transcript of How to Identify Neuropsychological Processing Deficits in Children with SLD Milton J. Dehn, Ed.D.,...

Page 1: How to Identify Neuropsychological Processing Deficits in Children with SLD Milton J. Dehn, Ed.D., NCSP Schoolhouse Educational Services June 2014.

How to Identify Neuropsychological Processing Deficits in Children with SLD

Milton J. Dehn, Ed.D., NCSPSchoolhouse Educational Services

June 2014

Page 2: How to Identify Neuropsychological Processing Deficits in Children with SLD Milton J. Dehn, Ed.D., NCSP Schoolhouse Educational Services June 2014.

Notice of Copyright 2014

This PowerPoint presentation and accompanying materials are copyrighted by Milton J. Dehn and Schoolhouse Educational Services, LLC. They are not to be reprinted, copied, or electronically disseminated without written permission. To obtain permission, email [email protected].

Page 3: How to Identify Neuropsychological Processing Deficits in Children with SLD Milton J. Dehn, Ed.D., NCSP Schoolhouse Educational Services June 2014.

Workshop Information Sources

• Essentials of Processing Assessment, 2nd Ed. • Children’s Psychological Processes Scale (CPPS)• Psychological Processing Analyzer (PPA)• Numerous references and articles on

processing assessment and interventions• www.psychprocesses.com• Presenter Contact: [email protected]

Page 4: How to Identify Neuropsychological Processing Deficits in Children with SLD Milton J. Dehn, Ed.D., NCSP Schoolhouse Educational Services June 2014.
Page 5: How to Identify Neuropsychological Processing Deficits in Children with SLD Milton J. Dehn, Ed.D., NCSP Schoolhouse Educational Services June 2014.

What are Neuropsychological Processes?

1. Brain processes, operations, functions2. Include “cognitive” processes3. When information is perceived, transformed,

manipulated, stored, retrieved, expressed4. Whenever we think, reason, problem-solve5. Both basic and higher level processes6. For SLD assessment, focus on broad

processes related to academics

Page 6: How to Identify Neuropsychological Processing Deficits in Children with SLD Milton J. Dehn, Ed.D., NCSP Schoolhouse Educational Services June 2014.

Neuropsychological Processes are Not

1. Not IQ, but they contribute to IQ2. Not “abilities”, but are more the specific brain

processes that underlie abilities3. More like aptitudes than abilities; aptitudes

are more specific, abilities are more general4. Not skills; skills and knowledge are the product

of processes 5. Dehn: not include sensory, motor, social-

emotional when conducting SLD assessment

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Processes for SLD Assessment

1. Attention2. Auditory Processing3. Executive Functions4. Fine Motor5. Fluid Reasoning6. Long-Term Recall7. Oral Language8. Phonological Processing9. Processing Speed10.Visual-Spatial Processing11.Working Memory (WM)

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Processes and Academic Learning

1. Psychological processes are like “aptitudes”2. Relations established through research

1. Flanagan et al., & McGrew2. Swanson, Geary, and others

3. The influence of processes varies by age4. For SLD look for academic area and related

psychological processes to both be low5. See Table

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Processes and Scores Allowed in Dehn’s Assessment Model

1. The list of 11 processes2. Rating scales 3. Composite scores preferred over subtest

scores4. Achievement-like scores such as verbal,

crystallized intelligence, vocabulary are excluded

5. Some subtests are re-classified

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Task Analysis/Classificationof Subtests

1. Consider definition of the process2. Consider factor analytic information3. What is the primary process being measured

by the subtest? (not just input or output)4. Which primary process allows the examinee

to successfully complete the task5. What the task is typically used to measure6. No such thing as “pure” subtest measure

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Selective & Cross-Battery Testing

1. Start with batteries you have2. Try to limit number of supplemental batteries3. Avoid redundancies4. Tests should be normed about the same time5. Only selected subtests administered6. Two subtests or composites are ideal7. May include rating scales8. Use cross-battery analysis procedures

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Cross-Battery, Selective Testing

1. Test all processes important for academics with most attention to an in-depth assessment of hypothesized weaknesses

2. Pick composites first3. See selective testing table Link4. See comprehensive list link from Essentials

of Processing Assessment, 2nd Edition

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Dehn’s PSW Requirements

1. Intra-individual weaknesses are statistically significant

2. At least one process is a deficit (see definition)3. The deficit is related to the deficient academic skill4. Subtest scores must be unitary for a deficit5. There is at least one strength (a processes that is

in average range)6. Consistency between low process score(s) and the

related low academic skill score

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Guidelines for Weaknesses & Deficits

1. Scores below 90 are normative weaknesses2. Intra-individual strengths & weaknesses use

12 points 1. Assumes composites/subtests have hi reliability

3. Deficit = both normative and intra-individual weakness

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Dehn’s Definition of Deficit

1. 3 reasons for deficit emphasis1. Both weaknesses together is

statistically rare2. A deficit indicates an underlying

neurological impairment3. Students with both kinds of

weaknesses really need special ed.

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When to Use IQ Instead of Cross-Battery Mean

1. Okay to use IQ as predictor because it has high correlations with most processes

2. Is technically more appropriate because it has known reliability and SEM

3. Use when only weak processes tested4. Use when only a few processes tested5. Use when a legal challenge is anticipated

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Processing Analysis Worksheet

1. Composite scores from test manual when possible2. Convert all scores to standard scores3. Compute clinical scores by averaging4. Compute processing mean or use IQ5. Calculate discrepancies6. Determine weaknesses and deficits7. Both kinds of weaknesses = a deficit8. Do pairwise comparisons

1. Opposites and those closely related9. Completed Example

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Pairwise Comparisons

1. For intervention planning, not diagnosis2. Pay most attention to:

1. Opposites2. Those that are closely related

3. A greater discrepancy is required for significance

4. Significant when confidence intervals do not overlap

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Non-Unitary Scores

1. When standard score difference is greater than 22 points (or 15 points)

2. Something different is being measured or something is different about the subtest task

3. Investigate further with more testing if cannot be explained

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Using Dehn’s Automated Analysis Worksheet to Determine PSW

1. Automated worksheet from Essentials of Processing, 2nd Edition

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Psychological Processing Analyzer 2.0

1. Available at www.psychprocesses.com2. Identifies statistically significant strengths,

weaknesses, deficits, and assets 3. Can enter composite and/or subtest scores4. 11 psychological processes5. Takes scores (almost 400 to choose from)

from more than 40 different scales: cognitive, achievement, rating, and processing

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Psychological Processing Analyzer

1. Some subtests are re-classified based on the primary demands of the task

2. Options: Use the mean of the process scores or IQ as predicted score

3. Differences greater than critical values are intra-individual weaknesses

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PPA Equations

1. Converts all scores to mean of 100; SD of 152. .01 or .05 level of significance3. Difference formulas based on reliability

coefficients of composites/subtests4. Regression toward the mean 5. Predicted score based on mean of other 106. Non-unitary scores are flagged

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PPA Demo and Report

1. See demo 2. See sample report3. Report has table, graph, and narrative4. Pairwise comparisons also provided 5. Identifies academic areas associated with the

identified deficits

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Using a Rating Scale toAssess Processes

1. Processing deficits are manifested through behaviors

2. Behavior ratings by teachers can be used to measure processing abilities

3. Examples: BRIEF and other Executive Function Scales

4. Also, the new CPPS5. Use the CPPS for processes not directly tested

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Children’s Psychological Processes Scale (CPPS) Overview

1. Standardized teacher rating scale2. Ages 5-0-0 to 12-11-303. 121 items across 11 subscales4. Entirely online, internet-web based5. Online administration time of 15 minutes6. Online scoring and report7. Author: Milton Dehn; published by Schoolhouse

Educational Services, 20128. Measurement Consultant: Kevin McGrew

Page 27: How to Identify Neuropsychological Processing Deficits in Children with SLD Milton J. Dehn, Ed.D., NCSP Schoolhouse Educational Services June 2014.

Main Purpose of the CPPS

1. To identify psychological (cognitive) processing weaknesses in children referred for a learning disability evaluation

1. An additional source of data for diagnostic purposes

2. Can be used as a Pattern of Strengths and Weaknesses (PSW) analysis

3. Covers processes not directly tested

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The CPPS Identifies Children with SLD

1. LD subjects had significantly higher means on all subscales; about 1.5 SD difference Link

2. The CPPS has high classification accuracy in regards to LD1. 37 LD subjects compared with matched controls2. Using CPPS GPA cutoff of 60 had 92%

classification accuracy across 74 subjects

Page 29: How to Identify Neuropsychological Processing Deficits in Children with SLD Milton J. Dehn, Ed.D., NCSP Schoolhouse Educational Services June 2014.

CPPS Standardization

1. 1,121 students rated by 278 teachers2. 128 communities in 30 states in U.S.3. All data collected online4. Demographics match U.S. Census well5. Norms: 4 age groups (5-6; 7-8; 9-10; 11-12)6. Included children with disabilities

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CPPS Processes

1. Attention2. Auditory Processing3. Executive Functions4. Fine Motor5. Fluid Reasoning6. Long-Term Recall7. Oral Language8. Phonological Processing9. Processing Speed10.Visual-Spatial Processing11.Working Memory (WM)

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CPPS General Processing Ability (GPA)

1. Based on average of all process scores2. Emerges from factor analysis; similar to

concept of general intelligence3. Processes function in an inter-related fashion4. Most processes contribute to any given

behavior, task5. On CPPS defined as “the underlying efficiency

of processing”

Page 32: How to Identify Neuropsychological Processing Deficits in Children with SLD Milton J. Dehn, Ed.D., NCSP Schoolhouse Educational Services June 2014.

Additional CPPS Factors

1. Second factor is Attention, EF, and WM: Self-Regulatory Processes (SRP)

2. Third factor is Fine Motor and Visual-Spatial: Visual-Motor processes

3. Clusters: Memory, Language4. WM loads higher on GPA than SRP: WM is

both a cognitive and an executive process because it includes STM and WM

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How the Web-Based CPPS Works

1. A psychologist side and a teacher side2. Psychologist manages & has student records3. Teachers can only access blank rating forms4. Once teacher has completed ratings,

completed form goes to psychologist’s side and teacher can no longer access

Page 34: How to Identify Neuropsychological Processing Deficits in Children with SLD Milton J. Dehn, Ed.D., NCSP Schoolhouse Educational Services June 2014.

Completing Teacher Rating Form

1. Takes approximately 15 minutes2. Responses: Never, Sometimes, Often, Almost

Always3. Must respond to all items4. Incomplete ratings will save and can be

completed later5. Free paper copies can be printed.

Psychologist then fills in ratings online.

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CPPS Items

1. What the teacher rater sees Link2. Regrouped by subscale after rating3. In developmental order (ability)

from lowest to highest item4. Example of scoring in

developmental sequence Link

Page 36: How to Identify Neuropsychological Processing Deficits in Children with SLD Milton J. Dehn, Ed.D., NCSP Schoolhouse Educational Services June 2014.

CPPS Report

1. Brief narrative, graph, and a table of scores2. Change-sensitive W-scores3. T-scores; percentiles; confidence intervals4. Intra-individual strengths and weakness

discrepancy table5. T-score to standard score converter6. Example

Page 37: How to Identify Neuropsychological Processing Deficits in Children with SLD Milton J. Dehn, Ed.D., NCSP Schoolhouse Educational Services June 2014.

CPPS Discrepancy Analysis

1. Use discrepancy table to determine pattern of strengths and weaknesses

2. Predicted score based on mean of other 103. Regression toward the mean included 4. +/- 1.00 to 2.00 SD of SEE discrepancy options5. Strengths and Weakness labeling is opposite

of discrepancy, e.g. “-” value = a strength6. Link

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T-Score Conversion Table

1. Optional2. Purpose: To see how consistent CPPS scores

are with achievement and cognitive scores3. T-score x 1.5 + 25 and then reverse distance

from mean4. Example: T-score of 60 x 1.5 = 90 + 25 = 1155. Then subtract 15 from 100 = 85 Example

Page 39: How to Identify Neuropsychological Processing Deficits in Children with SLD Milton J. Dehn, Ed.D., NCSP Schoolhouse Educational Services June 2014.

Diagnosing LD with the CPPS

1. Look for pattern of strengths and weaknesses (discrepancy table)

2. Weaknesses should also be normative weaknesses (T-scores above 60)

3. Look at Table to identify “deficits”4. Weaknesses should link to evidence-based

achievement relations 5. Same criteria as PSW model

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CPPS Reliability

1. Internal consistency subscale reliability ranges from .88 to .98

2. .99 on Total Score3. Inter-rater reliability

1. Range of .21 to .902. Median coefficient of 76.5

Page 41: How to Identify Neuropsychological Processing Deficits in Children with SLD Milton J. Dehn, Ed.D., NCSP Schoolhouse Educational Services June 2014.

Correlations with Achievement

1. High correlations with WJ III Achievement Test scores Link1. The broader the achievement score, the higher

the correlations

Page 42: How to Identify Neuropsychological Processing Deficits in Children with SLD Milton J. Dehn, Ed.D., NCSP Schoolhouse Educational Services June 2014.

Correlations with WJ III COG

1. Fewer correlations than achievement Link2. All CPPS processes have significant

correlations with Cognitive Fluency (ability to quickly and fluently perform cognitive tasks)

3. Most CPPS scales expected to link with WJ III COG tests do, except attention, processing speed, and WM (but does relate with STM)

4. Also, discriminant evidence

Page 43: How to Identify Neuropsychological Processing Deficits in Children with SLD Milton J. Dehn, Ed.D., NCSP Schoolhouse Educational Services June 2014.

CPPS Correlations with BRIEF

1. CPPS Attention, Executive Functions, and Working Memory (SRP Factor) have the highest correlations with all BRIEF scales

2. CPPS Attention and EF mostly are >.70 indicating they measure same domains as BRIEF Link

3. Other CPPS scales correlate with BRIEF metacognitive scales but not behavioral

Page 44: How to Identify Neuropsychological Processing Deficits in Children with SLD Milton J. Dehn, Ed.D., NCSP Schoolhouse Educational Services June 2014.

Questions